PDF herunterladen
CC BY-NC-ND 4.0 · Asian J Neurosurg 2020; 15(04): 889-898
DOI: 10.4103/ajns.AJNS_374_20
Original Article

Getting more out of follow-up three-dimensional time-of-flight magnetic resonance angiography in endovascularly treated intracranial aneurysms

Rajendra Phadke
1   Department of Radiodiagnosis and Interventional Radiology, Apollomedics Superspeciality Hospitals
2   Department of (former Prof. and Head), Department of Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow
,
Vivek Singh
3   Department of Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow
,
Madan Balaguruswamy
4   Department of (former Neuroradiology fellow) Department of Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow
5   Department of Interventional Radiology, Royal Care Super Speciality Hospital, Coimbatore
,
Alok Udiya
4   Department of (former Neuroradiology fellow) Department of Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow
6   Department of Interventional Radiology, CHL Hospital, Indore
,
Gurucharan Shetty
4   Department of (former Neuroradiology fellow) Department of Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow
7   Department of Radiology, Fortis Hospital and Cancer Institute, Bengaluru, Karnataka
,
Surya Prasad
3   Department of Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow
,
Somit Mittal
4   Department of (former Neuroradiology fellow) Department of Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow
8   Mittal Diagnostic Centre, Aligarh
,
Gaurav Chauhan
4   Department of (former Neuroradiology fellow) Department of Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow
,
Vedita Dhull
4   Department of (former Neuroradiology fellow) Department of Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow
,
Zafar Neyaz
3   Department of Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow
› Institutsangaben
› Weitere Informationen
Auch verfügbar auf
   Lizenzen und Reprints

Background: We retrospectively re-evaluated follow-up three-dimensional (3D) time-of-flight (TOF) magnetic resonance angiography (MRA) in patients with aneurysms treated with coiling at our Institute. Aims: To document the type and frequency of postcoiling residue patterns as seen on follow-up MRA and to document their evolution with time where a further follow-up MRA was available. To assess the implications of the location of the aneurysm on residue and recurrence. Subjects and Methods: 3D TOF MRA for 104 aneurysms were evaluated for residue size and residue pattern. Mainly, three residue patterns were identified. The aneurysms were allocated to different groups depending on the location. Multiple MRA studies were available in subgroup 1* and subgroup 2* where the residue growth or reduction and pattern change was noted and residue growth rates were calculated. Results: Collectively 54 (51.92%) aneurysms showed occlusion (pattern 1 and 1A), 31 (29.81%) showed neck residue (pattern 2A, 2B and 2C) and 19 (18.27%) showed recurrence (pattern 3A, 3B and 3C, residue size >3 mm) at the last follow-up MRA. Type 2A/3A patterns were more common. In terms of residue and recurrence, the distally located aneurysms (Group 3) appeared to do well. For those showing growing residue/recurrence, the average growth rate was calculated at 0.094 mm/month and 0.15 mm/month, respectively, for subgroup 1* and subgroup 2*, although the difference was not statistically significant. With longer follow-up the persisting and growing residues from both the subgroups, not warranting early re-treatment, showed a low growth rate at approximately 0.05 mm/month. Conclusions: TOF MRA helps in identifying different residue patterns in coiled aneurysms. Serial follow-up MRA appears useful in showing the pattern and size changes in the residual aneurysm. Although more work is required in this regard, calculation of aneurysm/residue growth rate may be useful in prognostication and in scheduling further follow-up or retreatment. The risk factor related to the location of the aneurysm warrants further study.

Key-words:

Aneurysm - endovascular treatment - magnetic resonance angiography - recurrence

Financial support and sponsorship

Nil.




Publikationsverlauf

Eingereicht: 30. Juli 2020

Angenommen: 03. September 2020

Artikel online veröffentlicht:
16. August 2022

© 2020. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Vinuela F, Duckwiler G, Mawad M. Guglielmi detachable coil embolization of acute intracranial aneurysm: Perioperative anatomical and clinical outcome in 403 paients. J Neurosurg 1997;86:475-82.
  • 2 Byrne JV, Sohn MJ, Molyneux AJ, Chir B. Five-year experience in using coil embolization for ruptured intracranial aneurysms: Outcomes and incidence of late rebleeding. J Neurosurg 1999;90:656-63.
  • 3 Raymond J, Roy D. Safety and efficacy of endovascular treatment of acutely ruptured aneurysms. Neurosurgery 1997;41:1235-45.
  • 4 CARAT Investigators. Rates of delayed rebleeding from intracranial aneurysms are low after surgical and endovascular treatment. Stroke 2006;37:1437-42.
  • 5 Molyneux A, Kerr R, Stratton I, Sandercock P, Clarke M, Shrimpton J, et al. International Subarachnoid Aneurysm Trial (ISAT) Collaborative group. International Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: A randomized trial. Lancet 2002;360:1267 74.
  • 6 Raymond J, Guilbert F, Weill A, Georganos SA, Juravsky L, Lambert A, et al. Long-term angiographic recurrences after selective endovascular treatment of aneurysms with detachable coils. Stroke 2003;34:1398-403.
  • 7 Cognard C, Weill A, Spelle L, Piotin M, Castaings L, Rey A, et al. Long-term angiographic follow-up of 169 intracranial berry aneurysms occluded with detachable coils. Radiology 1999;212:348-56.
  • 8 Thornton J, Debrun GM, Aletich VA, Bashir Q, Charbel FT, Ausman J. Follow-up angiography of intracranial aneurysms treated with endovascular placement of Guglielmi detachable coils. Neurosurgery 2002;50:239-49.
  • 9 Sluzewski M, van Rooij WJ, Rinkel GJ, Wijnalda D. Endovascular treatment of ruptured intracranial aneurysms with detachable coils: Long-term clinical and serial angiographic results. Radiology 2003;227:720-4.
  • 10 Sluzewski M, van Rooij WJ, Slob MJ, Bescós JO, Slump CH, Wijnalda D. Relation between aneurysm volume, packing, and compaction in 145 cerebral aneurysms treated with coils. Radiology 2004;231:653-8.
  • 11 Ng P, Khangure MS, Phatouros CC, Bynevelt M, ApSimon H, McAuliffe W. Endovascular treatment of intracranial aneurysms with Guglielmi detachable coils: Analysis of midterm angiographic and clinical outcomes. Stroke 2002;33:210-7.
  • 12 Hayakawa M, Murayama Y, Duckwiler GR, Gobin YP, Guglielmi G, Viñuela F. Natural history of the neck remnant of a cerebral aneurysm treated with the Guglielmi detachable coil system. J Neurosurg 2000;93:561-8.
  • 13 Cognard C, Weill A, Castaings L, Rey A, Moret J. Intracranial berry aneurysms: Angiographic and clinical results after endovascular treatment. Radiology 1998;206:499-510.
  • 14 Fernandez Zubillaga A, Guglielmi G, Viñuela F, Duckwiler GR. Endovascular occlusion of intracranial aneurysms with electrically detachable coils: Correlation of aneurysm neck size and treatment results. AJNR Am J Neuroradiol 1994;15:815-20.
  • 15 Tamatani S, Ito Y, Abe H, Koike T, Takeuchi S, Tanaka R. Evaluation of the stability of aneurysms after embolization using detachable coils: Correlation between stability of aneurysms and embolized volume of aneurysms. AJNR Am J Neuroradiol 2002;23:762-7.
  • 16 Willinsky RA, Taylor SM, TerBrugge K, Farb RI, Tomlinson G, Montanera W. Neurologic complications of cerebral angiography: Prospective analysis of 2,899 procedures and review of the literature. Radiology 2003;227:522-8.
  • 17 Wallace RC, Karis JP, Partovi S, Fiorella D. Noninvasive imaging of treated cerebral aneurysms, part I: MR angiographic follow-up of coiled aneurysms. AJNR Am J Neuroradiol 2007;28:1001-8.
  • 18 Derdeyn CP, Graves VB, Turski PA, Masaryk AM, Strother CM. MR angiography of saccular aneurysms after treatment with Guglielmi detachable coils: Preliminary experience. AJNR Am J Neuroradiol 1997;18:279-86.
  • 19 Gonner F, Heid L, Remonda G, Nicoli G, Baumgartner R W, Godoy N, et al. Angiography with ultrashort echo times in cerebral aneurysms treated with Guglielmi detachable coils. AJNR Am J Neuroradiol 1998;19:1324 8.
  • 20 Brunereau L, Cottier JP, Sonier CB, Medioni B, Bertrand P, Rouleau P, et al. Prospective evaluation of time-of-flight MR angiography in the follow-up of intracranial saccular aneurysms treated with Guglielmi detachable coils. J Comput Assist Tomogr 1999;23:216-23.
  • 21 Kähärä VJ, Seppänen SK, Ryymin PS, Mattila P, Kuurne T, Laasonen EM. MR angiography with three-dimensional time-of-flight and targeted maximum-intensity-projection reconstructions in the follow-up of intracranial aneurysms embolized with Guglielmi detachable coils. AJNR Am J Neuroradiol 1999;20:1470-5.
  • 22 Anzalone N, Righi C, Simionato F, Scomazzoni F, Pagani G, Calori G, et al. Three-dimensional time-of-flight MR angiography in the evaluation of intracranial aneurysms treated with Guglielmi detachable coils. AJNR Am J Neuroradiol 2000;21:746-52.
  • 23 Weber W, Yousry TA, Felber SR, Henkes H, Nahser HC, Roer N, et al. Noninvasive follow-up of GDC-treated saccular aneurysms by MR angiography. Eur Radiol 2001;11:1792-7.
  • 24 Boulin A, Pierot L. Follow-up of intracranial aneurysms treated with detachable coils: Comparison of gadolinium-enhanced 3D time-of-flight MR angiography and digital subtraction angiography. Radiology 2001;219:108-13.
  • 25 Nome T, Bakke SJ, Nakstad PH. MR angiography in the follow-up of coiled cerebral aneurysms after treatment with Guglielmi detachable coils. Acta Radiol 2002;43:10-4.
  • 26 Leclerc X, Navez JF, Gauvrit JY, Lejeune JP, Pruvo JP. Aneurysms of the anterior communicating artery treated with Guglielmi detachable coils: Follow-up with contrast-enhanced MR angiography. AJNR Am J Neuroradiol 2002;23:1121-7.
  • 27 Cottier JP, Bleuzen Couthon AB, Gallas S, Vinikoff-Sonier CB, Bertrand P, Domengie F, et al. Intracranial aneurysms treated with Guglielmi detachable coils: Is contrast material necessary in the follow up with 3D time of flight MR angiography? AJNR Am J Neuroradiol 2003;24:1797 803.
  • 28 Westerlaan HE, van der Vliet AM, Hew JM, Meiners LC, Metzemaekers JD, Mooij JJ, et al. Time-of-flight magnetic resonance angiography in the follow-up of intracranial aneurysms treated with Guglielmi detachable coils. Neuroradiology 2005;47:622-9.
  • 29 Menke J, Schramm P, Sohns JM, Kallenberg K, Staab W. Diagnosing flow residuals in coiled cerebral aneurysms by MR angiography: Meta-analysis. J Neurol 2014;261:655-62.
  • 30 van Amerongen MJ, Boogaarts HD, de Vries J, Verbeek AL, Meijer FJ, Prokop M, et al. MRA versus DSA for follow-up of coiled intracranial aneurysms: A meta-analysis. AJNR Am J Neuroradiol 2014;35:1655-61.
  • 31 Majoie CB, Sprengers ME, van Rooij WJ, Lavini C, Sluzewski M, van Rijn JC, et al. MR angiography at 3T versus digital subtraction angiography in the follow-up of intracranial aneurysms treated with detachable coils. AJNR Am J Neuroradiol 2005;26:1349-56.
  • 32 Shankar JJS, Lum C, Parikh N, dos Santos M. Long term prospective follow up of intracranial aneurysm treated with endovascular coiling using contrast enhanced MR Angiography. AJNR 2010;31:1211-5.
  • 33 Lindvall P, Borota L, Birgander R, Jonasson P, Ridderheim PÅ. Long-term follow-up of intracranial aneurysms treated with endovascular coiling: Experience from one institution. Vasc Endovascular Surg 2012;46:325-8.
  • 34 Levent A, Yuce I, Eren S, Ozyigit O, Kantarci M. Contrast-enhanced and time-of-flight MR angiographic assessment of endovascular coiled intracranial aneurysms at 1.5 T. Interv Neuroradiol 2014;20:686-92.
  • 35 Sprengers ME, Schaafsma JD, van Rooij WJ, van den Berg R, Rinkel GJ, Akkerman EM, et al. Evaluation of the occlusion status of coiled intracranial aneurysms with MR angiography at 3T: Is contrast enhancement necessary? AJNR Am J Neuroradiol 2009;30:1665-71.
  • 36 Pierot L, Portefaix C, Boulin A, Gauvrit JY. Follow-up of coiled intracranial aneurysms: Comparison of 3D time-of-flight and contrast-enhanced magnetic resonance angiography at 3T in a large, prospective series. Eur Radiol 2012;22:2255-63.
  • 37 Anzalone N, Scomazzoni F, Cirillo M, Righi C, Simionato F, Cadioli M, et al. Follow-up of coiled cerebral aneurysms at 3T: Comparison of 3D time-of-flight MR angiography and contrast-enhanced MR angiography. AJNR Am J Neuroradiol 2008;29:1530-6.
  • 38 Anzalone N, De Filippis C, Scomazzoni F, Calori G, Iadanza A, Simionato F, et al. Longitudinal follow up of coiled intracranial aneurysms: The impact of contrast enhanced MRA in comparison to 3DTOF MRA at 3T. Neurovascular Imging 2015;1: Article Number 11.
  • 39 Nakiri GS, Santos AC, Abud TG, Aragon DC, Colli BO, Abud DG. A comparison between magnetic resonance angiography at 3 Teslas (time-of-flight and contrast-enhanced) and flat-panel digital subtraction angiography in the assessment of embolized brain aneurysms. Clinics (Sao Paulo) 2011;66:641-8.
  • 40 Mascitelli JR, Moyle H, Oermann EK, Polykarpou MF, Patel AA, Doshi AH, et al. An update to the raymond-roy occlusion classification of intracranial aneurysms treated with coil embolization. J Neurointerv Surg 2015;7:496-502.
  • 41 Dorfer C, Gruber A, Standhardt H, Bavinzski G, Knosp E. Management of residual and recurrent aneurysms after initial endovascular treatment. Neurosurgery 2012;70:537-53.
  • 42 Roy D, Milot G, Raymond J. Endovascular treatment of unruptured aneurysms. Stroke 2001;32:1998-2004.
  • 43 Ferns SP, Sprengers ME, van Rooij WJ, van Zwam WH, de Kort GA, Velthuis BK, et al. Late reopening of adequately coiled intracranial aneurysms: Frequency and risk factors in 400 patients with 440 aneurysms. Stroke 2011;42:1331-7.
  • 44 Schaafsma JD, Velthuis BK, van den Berg R, Brouwer PA, Majoie CB, Barkhof F, et al. Coil-treated aneurysms: Decision making regarding additional treatment based on findings of MR angiography and intraarterial DSA. Radiology 2012;265:858-63.