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. 2015 Nov 27;49(4):341-6.
doi: 10.1515/raon-2015-0044. eCollection 2015 Dec.

Analysis of risk factors for perifocal oedema after endovascular embolization of unruptured intracranial arterial aneurysms

Snezana Lukic  1 , Slobodan Jankovic  2 , Katarina Surlan Popovic  3 , Dragic Bankovic  4 , Peter Popovic  3 , Milan Mijailovic  1
Affiliations

Analysis of risk factors for perifocal oedema after endovascular embolization of unruptured intracranial arterial aneurysms

Snezana Lukic et al. Radiol Oncol. .

Abstract

Background: Endovascular embolization is a treatment of choice for the management of unruptured intracranial aneurysms, but sometimes is complicated with perianeurysmal oedema. The aim of our study was to establish incidence and outcomes of perianeurysmal oedema after endovascular coiling of unruptured intracranial aneurysms, and to reveal possible risk factors for development of this potentially serious complication.

Methods: In total 119 adult patients with endovascular embolization of unruptured intracranial aneurysm (performed at Department for Interventional Neuroradiology, Clinical Center, Kragujevac, Serbia) were included in our study. The embolizations were made by electrolite-detachable platinum coils: pure platinum, hydrophilic and combination of platinum and hydrophilic coils. Primary outcome variable was perianeurysmal oedema visualized by magnetic resonance imaging (MRI) 7, 30 and 90 days after the embolization.

Results: The perianurysmal oedema appeared in 47.6% of patients treated with hydrophilic coils, in 21.6% of patients treated with platinum coils, and in 53.8% of those treated with mixed type of the coils. The multivariate logistic regression showed that variables associated with occurrence of perianeurysmal oedema are volume of the aneurysm, hypertension, diabetes and smoking habit. Hypertension is the most important independent predictor of the perianeurysmal oedema, followed by smoking and diabetes.

Conclusions: The results of our study suggest that older patients with larger unruptured intracranial aneurysms, who suffer from diabetes mellitus and hypertension, and have the smoking habit, are under much higher risk of having perianeurysmal oedema after endovascular coiling.

Keywords: endovascular embolization; hypertension; intracranial aneurysms; perianeurysmal oedema.

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Figures

FIGURE 1.
FIGURE 1.
T2W axial MR tomogram of a patient showing perifocal oedema in frontal region after embolization of the left ophtalmic artery aneurysm.
FIGURE 2.
FIGURE 2.
Digital subtraction angiography (DSA) of a patient after embolization of the unruptured left ophtalmic artery aneurysm, 13 × 10mm in diameter.
FIGURE 3.
FIGURE 3.
T2W axial MR tomogram of a patient showing minimal perifocal oedema in left frontal region after embolization of the anterior communicating artery aneurysm 5 × 5 mm in diameter.
FIGURE 4.
FIGURE 4.
Digital subtraction angiography (DSA) of a patient after endovascular embolization of the unruptured anterior communicating artery aneurysm, 5 × 5 mm in diameter.
FIGURE 5.
FIGURE 5.
The receiver-operator curve (ROC) for volume of the intracranial aneurysms and occurrence of the perianeurysmal oedema after endovascular embolization.
See this image and copyright information in PMC

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