Comparison of the association of sac growth and coil compaction with recurrence in coil embolized cerebral aneurysms

Anna L Hoppe; Madhavan L Raghavan; David M Hasan

doi:10.1371/journal.pone.0123017

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Comparison of the association of sac growth and coil compaction with recurrence in coil embolized cerebral aneurysms

Journal article

Open access

Peer reviewed

Comparison of the association of sac growth and coil compaction with recurrence in coil embolized cerebral aneurysms

Anna L Hoppe, Madhavan L Raghavan and David M Hasan

PloS one, Vol.10(4), pp.e0123017-e0123017

2015

DOI: 10.1371/journal.pone.0123017

PMCID: PMC4404091

PMID: 25894532

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Abstract

In recurrent cerebral aneurysms treated by coil embolization, coil compaction is regarded as the presumptive mechanism. We test the hypothesis that aneurysm growth is the primary recurrence mechanism. We also test the hypothesis that the coil mass will translate a measurable extent when recurrence occurs. An objective, quantitative image analysis protocol was developed to determine the volumes of aneurysms and coil masses during initial and follow-up visits from 3D rotational angiograms. The population consisted of 15 recurrence and 12 non-recurrence control aneurysms initially completely coiled at a single center. An investigator sensitivity study was performed to assess the objectivity of the methods. Paired Wilcoxon tests (p<0.05, one-tailed) were performed to assess for aneurysm and coil growth. The translation of the coil mass center at follow-up was computed. A Mann Whitney U-Test (p<0.05, one-tailed) was used to compare translation of coil mass centers between recurrence and control subjects. Image analysis protocol was found to be insensitive to the investigator. Aneurysm growth was evident in the recurrence cohort (p=0.003) but not the control (p=0.136). There was no evidence of coil compaction in either the recurrence or control cohorts (recurrence: p=0.339; control: p=0.429). The translation of the coil mass centers was found to be significantly larger in the recurrence cohort than the control cohort (p=0.047). Aneurysm sac growth, not coil compaction, was the primary mechanism of recurrence following successful coil embolization. The coil mass likely translates to a measurable extent when recurrence occurs and has the potential to serve as a non-angiographic recurrence marker.

Recurrence

Demography

Humans

Middle Aged

Male

Embolization, Therapeutic

Case-Control Studies

Young Adult

Image Processing, Computer-Assisted

Intracranial Aneurysm - therapy

Adolescent

Adult

Female

Aged

Intracranial Aneurysm - pathology

Cohort Studies

Details

Title: Subtitle: Comparison of the association of sac growth and coil compaction with recurrence in coil embolized cerebral aneurysms
Creators: Anna L Hoppe - Department of Biomedical Engineering, University of Iowa, Iowa City, Iowa, United States of America
Madhavan L Raghavan - Department of Biomedical Engineering, University of Iowa, Iowa City, Iowa, United States of America
David M Hasan - Department of Neurosurgery, University of Iowa Carver College of Medicine, Iowa City, Iowa, United States of America
Resource Type: Journal article
Publication Details: PloS one, Vol.10(4), pp.e0123017-e0123017
DOI: 10.1371/journal.pone.0123017
PMID: 25894532
PMCID: PMC4404091
NLM abbreviation: PLoS One
ISSN: 1932-6203
eISSN: 1932-6203
Publisher: Public Library of Science; United States
Grant note: R03NS079227-01A1 / NINDS NIH HHS R01 HL083475 / NHLBI NIH HHS K08 NS082363 / NINDS NIH HHS K08NS082363-01A1 / NINDS NIH HHS R03 NS079227 / NINDS NIH HHS R01HL083475 / NHLBI NIH HHS
Language: English
Date published: 2015
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Neurosurgery; Otolaryngology
Record Identifier: 9984040279702771

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