TY - JOUR
T1 - Long-term outcomes of coil embolization of unruptured intracranial aneurysms
AU - Koyanagi, Masaomi
AU - Ishii, Akira
AU - Imamura, Hirotoshi
AU - Satow, Tetsu
AU - Yoshida, Kazumichi
AU - Hasegawa, Hitoshi
AU - Kikuchi, Takayuki
AU - Takenobu, Yohei
AU - Ando, Mitsushige
AU - Takahashi, Jun C.
AU - Nakahara, Ichiro
AU - Sakai, Nobuyuki
AU - Miyamoto, Susumu
N1 - Publisher Copyright:
© AANS 2018, except where prohibited by US copyright law
PY - 2018
Y1 - 2018
N2 - OBJECTIVE Long-term follow-up results of the treatment of unruptured intracranial aneurysms (UIAs) by means of coil embolization remain unclear. The aim of this study was to analyze the frequency of rupture, retreatment, stroke, and death in patients with coiled UIAs who were followed for up to 20 years at multiple stroke centers. METHODS The authors retrospectively analyzed data from cases in which patients underwent coil embolization between 1995 and 2004 at 4 stroke centers. In collecting the late (≥ 1 year) follow-up data, postal questionnaires were used to assess whether patients had experienced rupture or retreatment of a coiled aneurysm or any stroke or had died. RESULTS Overall, 184 patients with 188 UIAs were included. The median follow-up period was 12 years (interquartile range 11-13 years, maximum 20 years). A total of 152 UIAs (81%) were followed for more than 10 years. The incidence of rupture was 2 in 2122 aneurysm-years (annual rupture rate 0.09%). Nine of the 188 patients with coiled UIAs (4.8%) underwent additional treatment. In 5 of these 9 cases, the first retreatment was performed more than 5 years after the initial treatment. Large aneurysms were significantly more likely to require retreatment. Nine strokes occurred over the 2122 aneurysm-years. Seventeen patients died in this cohort. CONCLUSIONS This study demonstrates a low risk of rupture of coiled UIAs with long-term follow-up periods of up to 20 years. This suggests that coiling of UIAs could prevent rupture for a long period of time. However, large aneurysms might need to be followed for a longer time.
AB - OBJECTIVE Long-term follow-up results of the treatment of unruptured intracranial aneurysms (UIAs) by means of coil embolization remain unclear. The aim of this study was to analyze the frequency of rupture, retreatment, stroke, and death in patients with coiled UIAs who were followed for up to 20 years at multiple stroke centers. METHODS The authors retrospectively analyzed data from cases in which patients underwent coil embolization between 1995 and 2004 at 4 stroke centers. In collecting the late (≥ 1 year) follow-up data, postal questionnaires were used to assess whether patients had experienced rupture or retreatment of a coiled aneurysm or any stroke or had died. RESULTS Overall, 184 patients with 188 UIAs were included. The median follow-up period was 12 years (interquartile range 11-13 years, maximum 20 years). A total of 152 UIAs (81%) were followed for more than 10 years. The incidence of rupture was 2 in 2122 aneurysm-years (annual rupture rate 0.09%). Nine of the 188 patients with coiled UIAs (4.8%) underwent additional treatment. In 5 of these 9 cases, the first retreatment was performed more than 5 years after the initial treatment. Large aneurysms were significantly more likely to require retreatment. Nine strokes occurred over the 2122 aneurysm-years. Seventeen patients died in this cohort. CONCLUSIONS This study demonstrates a low risk of rupture of coiled UIAs with long-term follow-up periods of up to 20 years. This suggests that coiling of UIAs could prevent rupture for a long period of time. However, large aneurysms might need to be followed for a longer time.
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U2 - 10.3171/2017.6.JNS17174
DO - 10.3171/2017.6.JNS17174
M3 - Article
C2 - 29303448
AN - SCOPUS:85055530124
SN - 0022-3085
VL - 129
SP - 1492
EP - 1498
JO - Journal of neurosurgery
JF - Journal of neurosurgery
IS - 6
ER -