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Relationship between aneurysm volume and histologic healing after coil embolization in elastase-induced aneurysms: a retrospective study.

ABSTRACT: There are, to our knowledge, no histologic data correlating aneurysm volume with histologic healing following coil embolization of aneurysms. We report a retrospective study comparing histologic outcome with aneurysm volume in elastase-induced aneurysms in rabbits.Aneurysm volume and histologic healing after coil embolization were retrospectively analyzed in 37 elastase-induced aneurysms in rabbits. Aneurysm dimensions (including neck, width, height, and volume) were measured and calculated. Packing density (PD) was calculated. Angiographic results were evaluated as recurrence, stable, and progressive occlusion. An ordinal grading system was used to evaluate the histologic healing after embolization. Correlations among aneurysm volume, PD, and histologic healing were analyzed by conducting linear regression analysis.For all the aneurysms in this study, mean aneurysm volume was 80.8 +/- 48.6 mm(3) (from 22 to 192 mm(3)), mean PD was 30.4 +/- 8.3% (from 17% to 49%), and mean histologic score was 6.1 +/- 2.0 (from 0.5 to 9.5), respectively. Correlations between aneurysm volume and PD, aneurysm volume and histologic healing, and aneurysm packing and histologic healing were all significant (P < .01).In this study, aneurysms with smaller volumes and higher PD were associated with the most complete histologic healing. The incomplete healing seen in the larger aneurysms is consistent with the higher incidence of recurrences after endovascular treatment that is seen in large human aneurysms.

SUBMITTER: Ding YH

PROVIDER: S-EPMC2614357 | biostudies-literature | 2008 Jan

REPOSITORIES: biostudies-literature

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Relationship between aneurysm volume and histologic healing after coil embolization in elastase-induced aneurysms: a retrospective study.

Ding Y H YH Dai D D Kadirvel R R Lewis D A DA Cloft H J HJ Kallmes D F DF

AJNR. American journal of neuroradiology 20071009 1

<h4>Background and purpose</h4>There are, to our knowledge, no histologic data correlating aneurysm volume with histologic healing following coil embolization of aneurysms. We report a retrospective study comparing histologic outcome with aneurysm volume in elastase-induced aneurysms in rabbits.<h4>Materials and methods</h4>Aneurysm volume and histologic healing after coil embolization were retrospectively analyzed in 37 elastase-induced aneurysms in rabbits. Aneurysm dimensions (including neck, ...[more]

PMID: 17925370

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Project description:ObjectiveOutcomes of stent-assisted coil embolization (SACE) have not been well established in the setting of vertebrobasilar dissecting aneurysms (VBDAs) due to the low percentage of cases that need treatment and the array of available therapeutic options. Herein, we presented clinical and radiographic results of SACE in patients with VBDAs.Materials and methodsA total of 47 patients (M:F, 30:17; mean age ± SD, 53.7 ± 12.6 years), with a VBDA who underwent SACE between 2008 and 2014 at two institutions were evaluated retrospectively. Medical records and radiologic data were analyzed to assess the outcome of SACE procedures. Cox proportional hazards regression analysis was conducted to determine the factors that were associated with aneurysmal recanalization after SACE.ResultsStent-assisted coil embolization technically succeeded in all patients. Three cerebellar infarctions occurred on postembolization day 1, week 2, and month 2, but no other procedure-related complications developed. Immediately following SACE, 25 aneurysms (53.2%) showed no contrast filling into the aneurysmal sac. During a mean follow-up of 20.2 months, 37 lesions (78.7%) appeared completely occluded, whereas 10 lesions showed recanalization, 5 of which required additional embolization. Overall recanalization rate was 12.64% per lesion-year, and mean postoperative time to recanalization was 18 months (range, 3-36 months). In multivariable analysis, major branch involvement (hazard ratio [HR]: 7.28; p = 0.013) and the presence of residual sac filling (HR: 8.49, p = 0.044) were identified as statistically significant independent predictors of recanalization. No bleeding was encountered in follow-up monitoring.ConclusionStent-assisted coil embolization appears feasible and safe for treatment of VBDAs. Long-term results were acceptable in a majority of patients studied, despite a relatively high rate of incomplete occlusion immediately after SACE. Major branch involvement and coiled aneurysms with residual sac filling may predispose to recanalization.

Dataset Information

Relationship between aneurysm volume and histologic healing after coil embolization in elastase-induced aneurysms: a retrospective study.

Publications

Relationship between aneurysm volume and histologic healing after coil embolization in elastase-induced aneurysms: a retrospective study.

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