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. 2022 Aug 15;62(8):377-383.
doi: 10.2176/jns-nmc.2022-0052. Epub 2022 Jul 14.

Aspect Ratio Is Associated with Recanalization after Coiling of Unruptured Intracranial Aneurysms

Takeshi Hara  1 , Tetsu Satow  2 , Eika Hamano  1 , Naoki Hashimura  1 , Masatake Sumi  1 , Taichi Ikedo  1 , Tsuyoshi Ohta  1 , Jun C Takahashi  2 , Hiroharu Kataoka  1
Affiliations

Aspect Ratio Is Associated with Recanalization after Coiling of Unruptured Intracranial Aneurysms

Takeshi Hara et al. Neurol Med Chir (Tokyo). .

Abstract

The rate of recanalization after coil embolization for unruptured intracranial aneurysms (UIAs) is reported to occur around 11.3%-49%. This study aims to investigate the factors that influence the recanalization after coil embolization for UIAs in our institution. We retrospectively investigated 307 UIAs in 296 patients treated at our institution between April 2004 and December 2016. The stent-used cases were excluded. Cerebral angiography and 3D time-of-flight magnetic resonance angiography (TOF MRA) were used for evaluation of the postoperative occlusion status. Volume embolization ratio (VER), aneurysmal size, neck width, and aspect ratio (AR) were compared between the recanalized and non-recanalized groups. The mean follow-up period ranged from 6 to 172 months (mean: 79.0 ± 39.8 months). Recanalization was noted in 78 (25.4%) aneurysms, and 19 (6.2%) aneurysms required retreatment. There was no aneurysmal rupture during the follow-up period. Univariate analysis showed that the aneurysm size (p < 0.001), neck width (p < 0.001), AR (p = 0.003), and VER (p = 0.012) were associated with recanalization. Multivariate logistic regression analysis showed that the AR (p =0.004) and VER (p =0.015) were significant predictors of recanalization. To summarize, a higher AR and a lower VER could lead to recanalization after coil embolization of UIAs. Careful follow-up is required for coiled aneurysms with these features.

Keywords: aspect ratio; coil embolization; recanalization; unruptured intracranial aneurysms.

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Conflict of interest statement

Dr. Hara, Dr. Hamano, Dr. Hashimura, Dr. Sumi, Dr. Ikedo, Dr. Ohta, Dr. Takahashi, and Dr. Kataoka declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Dr. Satow reports research funding from Canon Medical Systems Corp., outside the submitted work.

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