Impact of size ratio on thromboembolic events based on diffusion-weighted imaging after coil embolization for unruptured basilar apex aneurysm

• Published in: Clinical neurology and neurosurgery 2023-05, Vol.228, p.107699-107699, Article 107699
• Main Authors: Suzuki, Ryotaro, Takigawa, Tomoji, Nagaishi, Masaya, Hyodo, Akio, Suzuki, Kensuke
• Format: Article
• Language: English
• Subjects: Age; Aneurysm; Aneurysms; Aspirin; Basilar apex aneurysms; Blood clots; Blood Vessel Prosthesis - adverse effects; Cardiovascular system; Catheters; Clinical outcomes; Coil embolization; Diabetes; Diffusion Magnetic Resonance Imaging; Diffusion-weighted imaging; Embolization; Embolization, Therapeutic - adverse effects; Embolization, Therapeutic - methods; Endovascular coiling; Humans; Hyperlipidemia; Hypertension; Intracranial Aneurysm - complications; Intracranial Aneurysm - diagnostic imaging; Intracranial Aneurysm - therapy; Magnetic resonance imaging; Medical imaging; Morphology; Multivariate analysis; Neck; Neurology; Retrospective Studies; Size ratio; Stents; Thromboembolic events; Thromboembolism; Thromboembolism - diagnostic imaging; Thromboembolism - epidemiology; Thromboembolism - etiology; Treatment Outcome; Vascular surgery; Veins & arteries
• ISSN: 0303-8467; 1872-6968
• DOI: 10.1016/j.clineuro.2023.107699

Coil embolization is one of the main endovascular treatment for basilar apex aneurysms (BAAs), and thromboembolic events are important complications of coil embolization. Even in small aneurysms, there is a risk of rupture, and aggressive treatment should be considered for unruptured BAAs. Using diffusion-weighted imaging (DWI), the study aimed to investigate thromboembolic events after coil embolization for unruptured BAAs by focusing on the absolute aneurysm size and relative aneurysm size (size ratio [SR]). To evaluate the predictors of thromboembolic events, patients were divided into those with and without hyperintensity on DWI after coil embolization. Patient and radiographic characteristics were compared between the two groups. SR was defined as the maximum aneurysm diameter divided by the average parent artery diameter. Fifty-six unruptured BAAs in 56 patients were investigated. The mean aneurysm size and SR were 7.61 ± 2.18 mm and 2.74 ± 1.45, respectively. Postprocedural hyperintensity on DWI was detected in 17 patients (30.4%). SR was significantly larger in the group with hyperintensity on DWI (3.75 ± 1.97 vs. 2.3 ± 0.82, P  3.0 was a significant predictor of thromboembolic events after coil embolization for unruptured BAAs (odds ratio: 12.15; 95% confidence interval: 2.95–49.98; P