Recanalisation of cerebral artery aneurysms treated endovascularly - a midterm follow-up

• Published in: Neurologia i neurochirurgia polska 2020-01, Vol.54 (6), p.524-530
• Main Authors: Tomalski, Witold, Knap, Daniel, Żak, Amadeusz, Binek, Łukasz, Dewerenda-Sikora, Milena, Krzan, Aleksandra, Puz, Przemysław, Tomalski, Maciej, Sieron, Dominik, Piwowarski, Wojciech, Kuczmik, Wacław, Lasek-Bal, Anetta
• Format: Article
• Language: English
• Subjects: Aneurysm, Ruptured - therapy; Aneurysms; Asymptomatic; Brain Ischemia; Cerebral Angiography; Embolization; Embolization, Therapeutic; Endovascular Procedures; Follow-Up Studies; Humans; Intracranial Aneurysm - diagnostic imaging; Intracranial Aneurysm - surgery; Middle Aged; Patients; Retrospective Studies; Stroke; Treatment Outcome
• ISSN: 0028-3843; 1897-4260
• DOI: 10.5603/PJNNS.A2020.0065

Endovascular methods of aneurysm treatment, as an alternative to neurosurgical clipping, have proved a welcome opportunity to treat patients with unruptured aneurysms or those disqualified from neurosurgical intervention. This paper presents our own experience of endovascular treatment of cerebral aneurysms in 107 patients. It includes clinical and technical data from the perioperative period and a 12-month radiological follow-up of 78 patients. Our retrospective evaluation covered patients with intracranial aneurysms treated endovascularly. The following were analysed: age, sex, neurological symptoms, and familial burden of intracranial aneurysm. Multivariate analysis was performed to determine independent factors of recanalisation of the cerebral aneurysm 12 months after embolisation. The data of 107 patients at a mean age of 61 years [57.09 ± 14.27] treated with embolisation was analysed. The indication for intervention in 16 patients was subarachnoid haemorrhage; in the remaining 91 cases, aneurysms were revealed during diagnostic procedures for different symptoms or during imaging examinations. The intracranial segment of the internal carotid artery and the anterior communicating artery were the most common locations for aneurysms. After embolisation, subarachnoid haemorrhage occurred in one patient, ischaemic stroke in two patients, and one patient died because of acute circulatory insufficiency. The functional status of 94 patients on the day of discharge from the department (on days 4-21) was very good. 78 patients completed a 12-month follow-up period. In 11 of those, a follow-up MR angiography revealed recanalisation 12 months after the intervention. Except for one patient reporting vertigo, aneurysm recanalisation procedures were asymptomatic. The only independent risk factor for recanalisation was the size of aneurysm > 10 mm; OR 3.0; CI [1.15-7.83] p = 0.0255. Embolisation of cerebral aneurysms is a safe method with few perioperative complications, and most of these are mild and transient.The size of the aneurysm during qualification for embolisation is a risk factor for recanalisation in the subsequent 12 months. Recanalisation of embolised cerebral aneurysms concerns less than 20% of patients in a one-year follow-up and is most often asymptomatic.