Journal article
DEFINING THE RISK OF RETREATMENT FOR ANEURYSM RECURRENCE OR RESIDUAL AFTER INITIAL TREATMENT BY ENDOVASCULAR COILING: A MULTICENTER STUDY
Neurosurgery, v 65(2), pp 311-315
01 Aug 2009
PMID: 19625910
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
OBJECTIVE: Endovascular treatment of intracranial aneurysms is less invasive than surgical repair but poses a higher risk for aneurysm recurrence, which may necessitate retreatment, thus adding to the long-term risk. Cerebrovascular neurosurgeons from 8 institutions in the United States and Puerto Rico collaborated to assess the risk of retreatment for residual or recurrent aneurysms after the initial endovascular coiling.
METHODS: Data were prospectively recorded for 311 patients with coiled intracranial aneurysms who underwent 352 retreatment procedures after angiographic or clinical recurrence (hemorrhage after initial coiling). Results analyzed included procedural complications and procedure-related morbidity. Morbidity was classified as major (modified Rankin scale score > 3) or minor, and temporary (<30 days) or permanent (>30 days).
RESULTS: Retreatment mortality was 0.85% per procedure and 0.96% per patient. Treatment-related rates were 0.32% per patient (0.28% per procedure) for permanent or temporary major disability; 1.29% for permanent minor disability (1.14% per procedure); and 1.61% for temporary minor disability (1.42% per procedure). Total risk for death or permanent major disability was 1.28% per patient and 1.13% per procedure.
CONCLUSION: Retreatment poses a low risk for patients with recurrences of intracranial aneurysms after initial coiling; this risk is smaller than that posed by the initial endovascular therapy. The risk of disability associated with retreatment for aneurysm recurrence after coiling must be considered prospectively in the choice of treatment but with the recognition that its effects are low in the overall management risk.
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Details
- Title
- DEFINING THE RISK OF RETREATMENT FOR ANEURYSM RECURRENCE OR RESIDUAL AFTER INITIAL TREATMENT BY ENDOVASCULAR COILING: A MULTICENTER STUDY
- Creators
- Andrew J. Ringer - University of Cincinnati Medical CenterRafael Rodriguez-Mercado - University of Puerto Rico, Medical Sciences CampusErol Veznedaroglu - Thomas Jefferson UniversityElad I. Levy - University at Buffalo, State University of New YorkRicardo A. Hanel - University at Buffalo, State University of New YorkRobert A. Mericle - Vanderbilt UniversityDemetrius K. Lopes - Rush University Medical CenterGiuseppe Lanzino - Illinois CollegeAlan S. Boulos - University at Albany, State University of New York
- Publication Details
- Neurosurgery, v 65(2), pp 311-315
- Publisher
- Oxford Univ Press
- Number of pages
- 5
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurosurgery
- Web of Science ID
- WOS:000268523200023
- Scopus ID
- 2-s2.0-70349321508
- Other Identifier
- 991021962290804721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Clinical Neurology
- Surgery