MR Angiography Follow-Up 5 Years after Coiling: Frequency of New Aneurysms and Enlargement of Untreated Aneurysms

Abstract

BACKGROUND AND PURPOSE:Patients with intracranial aneurysms are at risk for future development of new aneurysms and growth of additional untreated aneurysms. Because in previous long-term studies duration of follow-up varied widely, the time interval after which screening could be effective remains largely unknown. The purpose of this study was to assess the incidence of de novo aneurysm formation and the growth of additional untreated aneurysms in patients with coiled aneurysms followed up with MR angiography (MRA) after a fixed period of 5 years.

Pediatric Intracranial Aneurysms: New and Enlarging Aneurysms after Index Aneurysm Treatment or Observation

“…In a study of adult patients imaged with 3T MRA 5 years after brain aneurysm coiling, 1.54% had de novo aneurysms. 7 In a study of adult patients having undergone ICA occlusion for aneurysm treatment, 3T MRA at a mean of 50.3 months after takedown (range, 0 -107 months), showed no de novo aneurysms. 8 Our current study relies on catheter angiographic imaging follow-up, which may be more sensitive than 3T MRA for small aneurysms.…”

Long-Term Follow-Up of 1036 Cerebral Aneurysms Treated by Bare Coils: A Multicentric Cohort Treated between 1998 and 2003

“…The same observation was made in a recent surgical study. 23 Sprengers et al 11,20 found an incidence of de novo aneurysms in 1.5% of patients after 5 years. De novo aneurysms are extremely rare, but we should continue to follow all patients to proactively detect these malformations.…”

“…Decision to treat was made by consensus by the referring neurosurgeon and the interventional physician. The severity of subarachnoid hemorrhage was clinically assessed at the time of admission by using the Hunt and Hess (HH) grading scale 11 and the Fisher scale. For the HH scale, 18% of patients were admitted with clinical grade I (n ϭ 159); 40%, with grade II (n ϭ 312); 16%, with grade III (n ϭ 136); and 26%, with grade IV (n ϭ 197).…”

“…3 Some articles have been published pertaining to the stability of occlusions treated with detachable coils and the efficacy of providing protection against growth or regrowth of the aneurysm and consequent bleeding. [4][5][6][7][8][9][10][11][12][13][14][15][16] Long-term follow-up and the rate of recanalization due to coil compaction, typically caused by unfavorable morphologic characteristics such as lesion and neck size, remain a disadvantage compared with surgical treatment.…”

Risk Factors for Growth of Intracranial Aneurysms: A Systematic Review and Meta-Analysis

“…Twenty-one studies reported risk factors for aneurysm growth, including 3954 patients with 4990 aneurysms with 11,000 patient-years and 13,294 aneurysm-years of follow-up. 9,12,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] Eleven of these studies reported the rupture rate of growing aneurysms. Mean patient follow-up was 4.9 years, and median was 3.2 years.…”