Low Risk in Treating Previously Coiled Aneurysm

The risks associated with treating a recurrent or residual brain aneurysm that was initially treated by endovascular coiling are low, according to a new study.

Researchers at the University of Cincinnati (UC; OH, USA), the State University of New York (Buffalo, USA), the University of Puerto Rico (San Juan), and other institutions prospectively collected data recorded for 311 patients with coiled intracranial aneurysms who underwent 352 retreatment procedures after angiographic or clinical recurrence of hemorrhage (after the initial coiling). The results analyzed included procedural complications and procedure-related morbidity, classified as major or minor, and temporary (less than 30 days) or permanent (over 30 days).


The results showed that retreatment mortality was 0.85% per procedure and 0.96% per patient. Treatment-related rates were 0.32% per patient and 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). The total risk for death or permanent major disability was 1.28% per patient and 1.13% per procedure. A potential bias in the study, according to the researchers, was that surgeons could have chosen not to perform retreatment procedures on patients whose recurrent or residual aneurysm was too dangerous. The study was published in the August 2009 issue of Neurosurgery.

"This quantitative evidence is important to patients and physicians because there is often more than one way to treat a brain aneurysm,” said lead author Andrew Ringer, M.D., an associate professor, and director of endovascular neurosurgery at UC. "Having an aneurysm coiled and avoiding a surgical procedure that requires opening the skull can be a very attractive option for patients. On the downside, coiling carries a higher rate of aneurysm recurrence than the standard surgical treatment."

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State University of New York
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