Aneurysm Coiling Shows Successful Long-Term Results

A new study reveals that coiling--a minimally invasive procedure to treat aneurysms in the brain--is successful in preventing recurrent or first-time bleeding, years after initial treatment in those aneurysms considered inoperable.

Researchers at Saint Elisabeth Hospital (Tilburg, The Netherlands) conducted a retrospective analysis of 154 consecutive patients who underwent coiling over an 11-year period (January 1995-August 2006) on aneurysms on the tip of the basilar artery, located in front of the brain stem. In the 154 patients who underwent the procedure, 114 (74%) of the aneurysms had ruptured and 40 (26%) had not. Following treatment, 144 surviving patients received clinical follow-up up to 144 months, adding up to a total of 637 patient years.

Angiographic follow-up conducted on 138 patients up to 122 months revealed that 27 aneurysms (17.5%) re-opened over time; these patients underwent additional coiling. Of this number, 11 aneurysms repeatedly re-opened and were coiled up to a total of six times. Re-bleeding occurred in only two patients, indicating an overall annual risk of 0.3% for re-bleeding after treatment. In all cases, aneurysm size greater than 10 mm was the only significant predictor for re-treatment at follow-up. The study was presented at the fourth annual meeting of the American Society of Interventional & Therapeutic Neuroradiology (ASITN), held at Dana Point (CA, USA) during August 2007.

"This study represents a unique contribution to the scientific evidence that proves coiling to be a viable treatment option,” said study presenter neurointerventional radiologist Jo Peluso, M.D, from University Hospital Gasthuisberg (Leuven, Belgium). "Our strict clinical and angiographic follow-up strategy with additional treatment when necessary was effective in preventing recurrent hemorrhage in ruptured aneurysms, or primary hemorrhage in unruptured aneurysms.”

Basilar tip aneurysms pose particular difficulties as their position deep in the brain makes a traditional, open neurosurgic approach more dangerous for the patient. Coiling, achieved by placing a mesh of platinum wires in the aneurysm, prevents the aneurysm from rupturing, a serious and often life-threatening condition.


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