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Stability of ruptured intracranial aneurysms treated with detachable coils: is delayed follow-up angiography warranted?

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Tailor, Jignesh Goetz, Pablo Chandrashekar, Hoskote Stephen, Tina Schiariti, Marco Grieve, Joan Watkins, Lawrence Brew, Stefan Robertson, Fergus Kitchen, Neil
Description	Country affiliation: United kingdom Author Affiliation: Tailor J ( Victor Horsley Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK.)
Abstract	The optimal strategy for monitoring the stability of ruptured intracranial aneurysms following coil embolisation is unclear. The value of delayed follow-up angiography in detecting new recurrences or progression of residual lesions visualised on earlier angiographic studies was determined in the light of the increasing use of non-invasive imaging techniques such as time of flight magnetic resonance angiography (TOF-MRA) for the evaluation of intracranial aneurysm occlusion. Ninety-seven patients with 105 ruptured aneurysms treated with detachable coils in 2005 and 2006 were included. The presence of a residual neck or aneurysm was assessed on catheter angiograms performed at 6 months and 2 years using the Raymond criteria (Class I = completely occluded, class II = small residual neck, class III = aneurysm sac filling). At 6-month follow-up, 32% of class I aneurysms progressed to class II and 6% of these aneurysms required re-treatment. A further 2-year angiogram was obtained in 59 patients with 65 aneurysms. Ninety-six per cent of class I, 100% of the class II and class III aneurysms remained unchanged at 2 years compared to 6 months. In our series, most recurrences were apparent at 6-month follow-up. The vast majority of coiled ruptured aneurysms that were class I or II at 6 months remained stable at 2-year follow-up. In the absence of a residual lesion in the early angiographic study, a further delayed catheter angiogram may not be warranted. The use of non-invasive strategies such as TOF-MRA should be considered.
File Format	HTM / HTML
ISSN	02688697
Issue Number	4
Volume Number	24
e-ISSN	1360046X
Journal	British Journal of Neurosurgery
Language	English
Publisher	Taylor & Francis
Publisher Date	2010-08-01
Publisher Place	Great Britain (UK)
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Neurosurgery Aneurysm, Ruptured Embolization, Therapeutic Methods Intracranial Aneurysm Stents Therapy Instrumentation Female Humans Magnetic Resonance Angiography Male Prospective Studies Radiography Recurrence Time Factors Treatment Outcome Journal Article
Content Type	Text
Resource Type	Article
Subject	Neurology (clinical) Surgery

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