Predisposing factors for recanalization of cerebral aneurysms after endovascular embolization: a multivariate study

Abstract

<div class="section"> <a class="named-anchor" id="S1"> <!-- named anchor --> </a> <h5 class="section-title" id="d15236087e209">Background</h5> <p id="P1">The recanalization of cerebral aneurysm after endovascular embolization (coiling or stent-assisted coiling) has been a matter of concern. We systematically evaluated the predisposing factors for cerebral aneurysm recanalization using multidimensional analysis in a large patient cohort. </p> </div><div class="section"> <a class="named-anchor" id="S2"> <!-- named anchor --> </a> <h5 class="section-title" id="d15236087e214">Methods</h5> <p id="P2">In 238 patients with 283 aneurysms, patient baseline characteristics, aneurysm morphological characteristics, treatment-related factors, and changes in flow hemodynamics after endovascular treatment (coiling or stent-assisted coiling) were compared between the recanalization and non-recanalization groups. Multivariate logistic regression analysis was performed to determine independent risk factors correlated with recanalization. </p> </div><div class="section"> <a class="named-anchor" id="S3"> <!-- named anchor --> </a> <h5 class="section-title" id="d15236087e219">Results</h5> <p id="P3">16 aneurysms treated by coiling recanalized, with a recurrence rate of 18.6%, and 24 recanalized in the lesions treated by stent-assisted coiling, with a recanalization rate of 12.2%. Large aneurysm (&gt;10 mm, <i>P</i>=0.002) and follow-up interval &gt;1 year ( <i>P</i>=0.027) were demonstrated statistically significant between the recanalization and non-recanalization groups. Regarding flow hemodynamics changes, three parameters (velocity on the neck plane, wall shear stress on the neck wall and wall shear stress on the whole aneurysm) showed relatively lower amplitude of decrease after endovascular treatment in the recanalization group. Interestingly, the velocity on the neck plane and wall shear stress on the neck wall may elevated after treatment. Specifically, the RR of velocity on the neck plane showed significant difference in the multivariate analysis ( <i>P</i>=0.013), which was considered an independent risk factor for recanalization. </p> </div><div class="section"> <a class="named-anchor" id="S4"> <!-- named anchor --> </a> <h5 class="section-title" id="d15236087e233">Conclusions</h5> <p id="P4">Besides the aneurysm size and follow-up interval, flow hemodynamic changes, especially the RR of velocity on the neck plane, played important roles in aneurysm recanalization. </p> </div>