脳動脈瘤コイル塞栓術の成否に影響を及ぼす要因の解析

概要

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To predict the angiographic outcome of coil embolization of aneurysms using Guglielmi detachable coils (GDCs), we evaluate angiographic findings after the initial treatment and follow-up angiography. Between May 1998 and October 2006, 94 intracranial aneurysms of 88 patients underwent endosaccular embolization with GDCs and follow-up angiography. We statistically analyzed the relationships between aneurysm size, volume embolization ratio (VER), aspect ratio (AR) and arterial geometry and findings on follow-up such as complete occlusion (CO) or incomplete occlusion (ICO). The geometry of the parent artery was subdivided into 3 categories; bifurcation, branching and lateral type. Following the initial treatment, we obtained CO in 74 aneurysms (78.7%) and ICO in 20 aneurysms. Of 74 CO cases, three cases later recanalized and were categorized as ICO. Progressive thrombosis was detected in 10 of 20 ICO cases on follow-up angiography. Branching or lateral aneurysms showed a high tendency toward CO. VER and size of aneurysm did not show any statistical difference between the two groups. However, the difference in AR was significant (p<0.05) between the two groups and aneurysms with an AR larger than 2.0 showed a high success ratio of 92.6%. AR is considered one of most useful indices predicting successful coil embolization for intracranial aneurysm.