3348

Preoperative clinical and imaging characteristics associated with aneurysm recurrence after stent-assisted coil embolization
bing tian1, Yuxi Hou1, Xia Tian1, and Jianping Lu1
1Changhai hospital of Shanghai, Shanghai, China

Synopsis

Keywords: Vessel Wall, Vessels

Motivation: In this retrospective observational cohort study, we found that both CAWE pattern and aspect ratio were independent predictors of aneurysm recurrence after stent-assisted coil embolization.

Goal(s): To explore the baseline clinical and imaging characteristics which can predict aneurysm recurrence after stent-assisted coil embolization.

Approach: 3D high-resolution MRI vessel wall imaging

Results: Among the 155 patients, 26 patients (16.7%) got aneurysm recurrence after stent-assisted coil embolization during the 2-year follow-up. Multivariate logistic regression analysis revealed that the CAWE pattern (OR 3.87, 95% CI 1.2–10.4, p=0.02) and aspect ratio (OR 2.1, 95% CI 0.6-4.2, p=0.03) were independently associated with aneurysm recurrence after stent-assisted coil embolization.

Impact: If validated in future larger-scale studies, preoperative imaging characteristics, especially vessel wall enhancement patterns on 3D HR-VWI could be a potential tool for identifying patients at elevated risk of recurrence after stent-assisted coil embolization.

Purpose: To explore the baseline clinical and imaging characteristics which can predict aneurysm recurrence after stent-assisted coil embolization.Material and Methods: This retrospective study included 155 patients with intracranial aneurysms who underwent stent-assisted coil embolization in our hospital. All patients underwent preoperative 3D high-resolution MRI vessel wall imaging (HR-VWI) as well as contrast enhancement MRA (CE-MRA). Regular radiographic follow-up was conducted to monitor for recurrence after embolization. Preoperative clinical (including sex, age, symptom, hypertension, smoking) and imaging (location, maximum size, neck width, aspect ratio, aneurysm vessel wall enhancement on HR-VWI) characteristics were recorded. Aneurysm vessel wall enhancement patterns were classified as circumferential AWE (CAWE), focal AWE (FAWE), and negative AWE (NAWE) groups. Univariable and multivariable logistic analyses were used to test the clinical and imaging factors associated with aneurysm recurrence after stent-assisted coil embolization.Result: Among the 155 patients, 26 patients (16.7%) got aneurysm recurrence after stent-assisted coil embolization during the 2-year follow-up. Aneurysm vessel wall enhancement patterns on preoperative HR-VWI were as follows:62 CAWE (40%), 48 FAWE (31%), and 45 NAWE (29%). Multivariate logistic regression analysis revealed that the CAWE pattern (OR 3.87, 95% CI 1.2–10.4, p=0.02) and aspect ratio (OR 2.1, 95% CI 0.6-4.2, p=0.03) were independently associated with aneurysm recurrence after stent-assisted coil embolization.Discussion: In this retrospective observational cohort study, we found that both CAWE pattern and aspect ratio were independent predictors of aneurysm recurrence after stent-assisted coil embolization. If validated in future larger-scale studies, preoperative imaging characteristics, especially vessel wall enhancement patterns on 3D HR-VWI could be a potential tool for identifying patients at elevated risk of recurrence after stent-assisted coil embolization.

Acknowledgements

None

References

[1] Shimonaga K, Matsushige T, Ishii D, et al. Clinicopathological insights from vessel wall imaging of unruptured intracranial aneurysms. Stroke. 2018; 49(10): 2516-2519.

[2] Zhang X, Zuo Q, Tang H, et al. Stent assisted coiling versus non-stent assisted coiling for the management of ruptured intracranial aneurysms: a meta-analysis and systematic review. J Neurointerv Surg. 2019; 11(5): 489-496.

[3] Fu Q, Wang Y, Zhang Y, et al. Qualitative and quantitative wall enhancement on magnetic resonance imaging is associated with symptoms of unruptured intracranial aneurysms.Stroke. 2021; 52(1): 213-222.

Figures

Figure. A 46-year-old man. Blurred vision in the right eye for 1 month; DSA revealed right ICA aneurysm(C); CAWE can be found on preoperative HR-VWI(A/B); Patients got stent-assisted coil embolization(D); Recurrence of aneurysm was found 1 year after embolization(E).

Proc. Intl. Soc. Mag. Reson. Med. 32 (2024)
3348
DOI: https://doi.org/10.58530/2024/3348