Digital subtraction angiography after intracranial aneurysm embolization:a follow-up study

Objective To explore the problems of recanalization and rebleeding after intracranial aneurysm embolization and the necessity of digital subtraction angiography(DSA)follow-up.Methods One hundred and two patients with intracranial aneurysm(114 aneurysms,of them,2 patients with multi- ple intracranial aneurysms,each with one small aneurysm did not coiled)were selected for endovascular embolization with Guglielmi detachable coil(GDC),electrolytical detachable coil(EDC),mechanical de- tachable spiral(MDS)or Matrix detachable microcoils and were followed-up by the DSA from January 1997 to January 2005.The mean follow-up period was 10.5 months(1 month to 6.5 years)after the proce- dures.They were compared with the immediate DSA images after the embolizations.Results Endovas- cular coiling procedures were performed in 112 aneurysms.100％occlusion was 51.79％(58/112)after the initial embolization,≥95％occlusion was 33.04％(37/112),and＜95％occlusion was 15.17％(17/112).After embolization,87(77.68％)patients the coils were stable,6 patients with residual an- eurysms(5.36％),and 19 aneurysms(16.96％)recanalized.Among the 90 aneurysms embolized with GDC or EDC,14(15.56％)reeanalized.Among the aneurysms with 100％,≥95％and＜95％occlu- sion,their recanalize rates after the procedures were 4.08％,26.67％and 36.36％,respectively,and there were significant differences among them(P＜0.01).Nine recanalized aneurysms were reembolized with GDC,and rebleeding did not occur.Among 5 recanalized aneurysms,1 aneurysm experienced re- bleeding later.Of the 18 aneurysms embolized with MDS recanalization,5 recanalized during the follow-up period.The aneurysms treated with Matrix detachable microcoils or Neuroform stents＋Matrix detachable microcoils,the aneurysms were occluded completely on follow-up DSA,even the inital occlusions were nearly complete or incomplete.Conclusion The recanalization of intracranial aneurysms is associated with the initial embolization and the embolic materials used.DSA follow-up should be emphasized,and ad- ditional coiling should be performed if the aneurysm is recanalized.