Re-treatment of patients with embolized ruptured intracranial aneurysms

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Objective: To establish a strategy for addressing recanalization of intracranial aneurysms previously embolized with Guglielmi detachable coils (GDC), efficacy and safety of additional treatments was evaluated.Methods: A total of 168 patients with acute ruptured intracranial aneurysms were subjected to GDC embolization. Follow-up angiograms were obtained 6 months, and 1 and 2 years post-embolization. Patients with major recanalization that had not disappeared at 1 year after the first embolization underwent retreatment.Results: Of the 168 patients, 18 (10.7%) underwent additional treatment, with 14 receiving a second coil embolization and 2 undergoing a total of 3 or more additional embolization procedures. One patient died after the 4th coil embolization. Both of the other 2 patients undergoing 3 or more embolization procedures required surgery, with it very difficult to achieve complete occlusion of the residual neck in one of them.Conclusions: Additional treatment of previously coil-embolized aneurysms is safe. The strategy of retreating patients with angiographically confirmed major recanalization at 1-year follow-up is appropriate.
特定非営利活動法人日本脳神経血管内治療学会の論文