Analysis of secondary intervention methods for recurrence intracranial aneurysm after intracranial embolization

Objective To compare the effects of different managements on recurrent aneurysms after embolization. Methods The retrospective cohort study was conducted. Clinical data of 101 patients who admitted at our institution from January 2010 to December 2016 were collected. There were 36 males and 65 females. The age of first onset was 15-69(45±11) years, the age of recurrence was 16-76(48±11) years. All of those patients were confirmed with intracranial recurrent aneurysms.According to the secondary intervention, the patients were divided into the operation group (24 cases), the embolization group (39 cases), the embolization+ stent group (30 cases), and the conservative group (8 cases). The patients were analyzed for changes in the modified RANKIN scale (mRS) score before and after treatment, whether there were complications after intervention, and whether they relapsed after intervention, and the effects of different intervention methods were judged. Results There were no significant differences in age, hypertension or diabetes, smoking, aneurysm rupture, aneurysm diameter and neck width, mRS score, and complication rate in the second group of patients with recurrent aneurysms(all P values>0.05). There were statistical differences in the aneurysms between the groups (χ2=37.485, P<0.05). There was no significant difference in mRS between the two groups before and after the second intervention.After the second intervention, 0 case recurred in the operation group, 10 cases (25.6%, 10/39) in the embolization group, 3 cases (10%, 3/30) in the embolization+ stent group, and 2 cases in the conservative group (2/8). There was a statistically significant difference in the recurrence rate of tumors (χ2=8.986, P<0.05). Conclusions Surgical clipping, endovascular embolization and coiling with stent are effective treatment methods for recurrent aneurysms. Among them, aneurysms with surgical clipping has a lower recurrence rate than interventional therapy.Close follow-up observation is needed for conservative patients with recurrent aneurysms. Key words: Intracranial aneurysm; Embolization, therapeutic; Recurrence; Radiology, intervention