Recurrence of intracranial aneurysms after endovascular embolization: study of 70 cases

Objective: To evaluate the factors of recurrence of intracranial aneurysm after endovascular embolization.

Methods: Seventy patients with 74 intracranial aneurysms, 37 males and 33 females, aged 47 (37-63), underwent endovascular embolization. Cerebral angiography was conducted 3 months to 1 year after the endovascular embolization on 37 patients. The geometric forms of aneurysm, method and material of endovascular embolization, and digital subtraction angiography (DSA) images before and after the recurrence were analyzed. geometry form, method and material of endovascular embolization and image.

Results: Nine recurrent aneurysms were discovered in 8 patients of which 5 were located in the posterior communicating artery; 2 in the anterior communicating artery;and 2 in the first crotch of the right middle cerebral artery. Four of the recurrent aneurysms were wide-necked aneurysms; and 5 were of irregular forms. Before recurrence, complete aneurysm occlusion was achieved in 3 aneurysms and incomplete occlusion was achieved in 6.

Conclusions: The percentage of complete aneurysm occlusion is related to the location, size, geometric form, method and material of endovascular embolization and density of coil packing. Intracranial aneurysms located in crotch of artery, with wide-neck, large, with irregular forms, and embolized incompletely are liable to recur.