From the Department of Neurosurgery (T.M., T.N., K.A., Y.K., H.N., H.K.), Osaka University Graduate School of Medicine, Osaka, Japan.
Department of Neurosurgery (T.M.), Osaka Neurological Institute, Osaka, Japan.
AJNR Am J Neuroradiol. 2019 Jul;40(7):1191-1196. doi: 10.3174/ajnr.A6101. Epub 2019 Jun 27.
The appropriate period of follow-up examinations after endovascular embolization for cerebral aneurysms using time-of-flight MR angiography is not well-known. We retrospectively investigated long-term results after endovascular embolization for unruptured cerebral aneurysms and evaluated the periods from embolization to recanalization and retreatment.
Between April 2006 and March 2011, one hundred forty-eight unruptured aneurysms were treated with endovascular coil embolization. Among them, we investigated 116 unruptured aneurysms, which were followed up for >5 years. Time-of-flight MR angiography was performed at 1 day, 3-6 months, 1 year after the procedure, and every year thereafter.
The mean follow-up period was 7.0 ± 1.4 years. Recanalization was observed in 19 (16.3%) aneurysms within 2 years. Among them, retreatment for recanalization was performed in 8 (6.8%) aneurysms. No recanalization was detected in any aneurysms that had been stable in the first 2 years after embolization. A larger maximum aneurysm size was significantly correlated with recanalization ( = .019).
Aneurysms in which recanalization was not observed within 2 years after endovascular coil embolization were stable during a mean follow-up of 7 years. This result may be helpful in considering the appropriate span or frequency of follow-up imaging for embolized cerebral aneurysms.
使用时间飞跃磁共振血管造影术对颅内动脉瘤进行血管内栓塞后,适当的随访检查时间尚不清楚。我们回顾性地研究了血管内栓塞未破裂颅内动脉瘤的长期结果,并评估了从栓塞到再通和再治疗的时间。
2006 年 4 月至 2011 年 3 月,148 例未破裂的动脉瘤采用血管内线圈栓塞治疗。其中,我们对 116 例未破裂的动脉瘤进行了>5 年的随访。术后第 1 天、3-6 个月、1 年和此后每年进行时间飞跃磁共振血管造影。
平均随访时间为 7.0 ± 1.4 年。2 年内观察到 19 个(16.3%)动脉瘤再通。其中,8 个(6.8%)动脉瘤因再通而进行了再治疗。栓塞后 2 年内稳定的动脉瘤均未发现再通。最大动脉瘤直径越大,再通的可能性越大(=0.019)。
血管内线圈栓塞后 2 年内未观察到再通的动脉瘤在平均 7 年的随访中保持稳定。这一结果可能有助于考虑栓塞颅内动脉瘤适当的随访成像时间间隔或频率。