REGULAR CONTENT
Final ID
414
Type
Original Scientific Research-Poster Only
Authors
A Hui1, M Wong1, M Schmidt1
Institutions
1Dalhousie University, Halifax, Nova Scotia
Purpose
One-fifth of intracranial aneurysms recur post-embolization with up to half of recurrences requiring re-treatment. The aim of this study was to explore new morphological risk factors for re-treatment as well as to confirm established predictors such as large dome and neck size, low packing density, and modified Raymond Roy classification score >1. We hypothesize that the risk of aneurysm recurrence is associated with small parent vessel-to-branch angles and dominant-to-inferior branch calibre ratios.
Materials & Methods
We reviewed postembolization digital subtraction angiograms of 21 patients who required re-treatment after coil embolization of an intracranial aneurysm (cases) and 21 patients who did not require re-treatment (controls) at a single institution between 1998 and 2008. Pairs were matched based on age, sex, aneurysm location, smoking status, rupture at presentation, and follow-up duration. One rater took blinded measurements of aneurysm dome and neck size, packing density, and scored neck remnants according to the modified Raymond Roy classification. Two raters independently took blinded parent vessel-to-branch angles at the site of aneurysms and branch caliber ratios. Univariate data analysis involved one-tailed paired Student t-tests for continuous variables and McNemar test for MRRC scores. The Holm-Bonferroni method corrected for multiple comparisons. Matched aneurysms were also typed in 2 categories according to various angle or product cut-offs and compared using McNemar tests in an exploratory fashion.
Results
Retreatment was significantly associated with larger dome height (p=0.0031), neck width (p=0.0376), and MRRC scores greater than 1 (p=0.0433). Low packing density (p=0.0609), small dominant-branch-to-parent vessel angles (p=0.057), and large dominant-to-inferior calibre ratios (p=0.3088) were insignificantly correlated with recurrence. Typing aneurysms into 2 groups for categorical comparison yielded insignificant differences in angles and calibre ratios.
Conclusions
Previously recognized risk factors e.g large dome height, large neck width, low packing density, and MRRC >1 may have greater predictive value than morphology in identifying at-risk patients for recurrence.
Final ID
414
Type
Original Scientific Research-Poster Only
Authors
A Hui1, M Wong1, M Schmidt1
Institutions
1Dalhousie University, Halifax, Nova Scotia
Purpose
One-fifth of intracranial aneurysms recur post-embolization with up to half of recurrences requiring re-treatment. The aim of this study was to explore new morphological risk factors for re-treatment as well as to confirm established predictors such as large dome and neck size, low packing density, and modified Raymond Roy classification score >1. We hypothesize that the risk of aneurysm recurrence is associated with small parent vessel-to-branch angles and dominant-to-inferior branch calibre ratios.
Materials & Methods
We reviewed postembolization digital subtraction angiograms of 21 patients who required re-treatment after coil embolization of an intracranial aneurysm (cases) and 21 patients who did not require re-treatment (controls) at a single institution between 1998 and 2008. Pairs were matched based on age, sex, aneurysm location, smoking status, rupture at presentation, and follow-up duration. One rater took blinded measurements of aneurysm dome and neck size, packing density, and scored neck remnants according to the modified Raymond Roy classification. Two raters independently took blinded parent vessel-to-branch angles at the site of aneurysms and branch caliber ratios. Univariate data analysis involved one-tailed paired Student t-tests for continuous variables and McNemar test for MRRC scores. The Holm-Bonferroni method corrected for multiple comparisons. Matched aneurysms were also typed in 2 categories according to various angle or product cut-offs and compared using McNemar tests in an exploratory fashion.
Results
Retreatment was significantly associated with larger dome height (p=0.0031), neck width (p=0.0376), and MRRC scores greater than 1 (p=0.0433). Low packing density (p=0.0609), small dominant-branch-to-parent vessel angles (p=0.057), and large dominant-to-inferior calibre ratios (p=0.3088) were insignificantly correlated with recurrence. Typing aneurysms into 2 groups for categorical comparison yielded insignificant differences in angles and calibre ratios.
Conclusions
Previously recognized risk factors e.g large dome height, large neck width, low packing density, and MRRC >1 may have greater predictive value than morphology in identifying at-risk patients for recurrence.