Wenjun Ji
Beijing Tiantan Hospital, Capital Medical University, China
Title: Larger inflow angle and incomplete occlusion predict recanalization of unruptured paraclinoid aneurysms after endovascular treatment
Biography
Biography: Wenjun Ji
Abstract
Background: Unruptured paraclinoid aneurysms have a high incidence of aneurysm recanalization (AR) after endovascular treatment. We aimed to identify the incidence and predictors of AR in these lesions. Methods: We retrospectively analyzed consecutive patients with unruptured paraclinoid aneurysms who underwent endovascular treatment between January 2013 and December 2014. Patients with fusiform aneurysms, dissection aneurysms, traumatic aneurysms, or without digital subtraction angiography (DSA) at follow-up, were excluded. AR was defined as any aneurysm remnant that had increased in size or contrast filling that was observed via DSA at the follow-up. Univariate and multivariate logistic regression analyses were performed to assess the predictors of AR. Results: We included 145 patients with 150 unruptured paraclinoid aneurysms in the analysis. The incidence of AR was 8.7% (95% confidence intervals [CI]: 4.7–13.3%) at a mean follow-up of 7.4 months. In the univariate analysis, AR was associated with aneurysm size (odd ratios [OR]: 6.098; 95% CI: 1.870–19.886; P = 0.003), location (OR: 3.88; 95% CI: 1.196–12.583; P = 0.024), inflow angle (OR: 6.852; 95% CI: 1.463–32.087; P = 0.015), and Raymond scale (OR: 12.473; 95% CI: 2.7496–56.59; P < 0.001). In the adjusted multivariate analysis, AR was independently predicted by Raymond scale (OR: 9.136; 95% CI: 1.683–49.587; P = 0.001) and inflow angle (OR: 16.159; 95% CI: 3.211–81.308; P = 0.01). Conclusions: Unruptured paraclinoid aneurysms had a high incidence of AR after endovascular treatment. An inflow angle of ≥90° and incomplete occlusion were significant predictors of AR.