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. 2022 Mar 15;62(3):118-124.
doi: 10.2176/nmc.oa.2021-0225. Epub 2021 Dec 8.

Usefulness of Craniograms in Discriminating Coiled Intracranial Aneurysms Requiring Retreatment

Ryuta Yasuda  1   2 , Tetsu Satow  1 , Naoki Hashimura  1 , Masaki Nishimura  1 , Jun C Takahashi  1 , Hiroharu Kataoka  1
Affiliations

Usefulness of Craniograms in Discriminating Coiled Intracranial Aneurysms Requiring Retreatment

Ryuta Yasuda et al. Neurol Med Chir (Tokyo). .

Abstract

While endovascular coil embolization has become one of the major therapeutic modalities for intracranial aneurysms, long-term imaging follow-up is required because of the higher rate of retreatment compared with surgical clipping. The purpose of this study was to show the usefulness of craniograms to discriminate coiled intracranial aneurysms that required retreatment. Under the study protocol approved by institutional review board, a retrospective review of the medical record was done regarding coil embolization for intracranial aneurysms performed between January 2014 and December 2018. Coil embolization performed as the initial treatment and followed up for more than 1 year without additional treatment, and those performed as retreatment after the initial coil embolization performed at our institution were recruited. Craniograms obtained just after the initial treatment were compared with those obtained just before the additional treatment in the retreated cases and compared with the latest ones in the non-recurrence cases. Correlation between the morphological changes in the coil mass on the craniograms and retreatments was evaluated. During the study period, 288 coil embolization procedures for intracranial aneurysms were performed. From these, 191 treatments that were followed up for more than 1 year without any additional treatments and 30 retreatments were included. Morphological change of the coil mass was observed in 4 of the 191 non-recurrence treatments and 26 of the 30 retreatments, which was significantly correlated with retreatments (p <0.001). Craniogram was a useful modality in following up the coiled intracranial aneurysms to detect those required retreatments.

Keywords: coil embolization; craniogram; intracranial aneurysm; retreatment.

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Conflict of interest statement

Conflicts of Interest Disclosure

The authors have no conflicts of interest to declare that are relevant to the content of this article.

Figures

Fig. 1
Fig. 1
Patterns of morphological changes in the coil mass. 1) Sparseness: a part of the coil mass gets sparse. 2) Cleft: a cleft crossing the coil mass is observed. 3) Fray: the margin of the coil mass gets frayed. 4) Sparseness and Fray: the combination of 1) and 3). 5) Deformation: the coil mass shows remarkable shrinkage or compaction.
Fig. 2
Fig. 2
Study flowchart. Pt: patient, f/u: follow-up, AN: aneurysm.
See this image and copyright information in PMC

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