• Young Dae Cho, Jin Pyeong Jeon, Dong Hyun Yoo, Won-Sang Cho, Hyun-Seung Kang, Jeong Eun Kim, and Moon Hee Han.
• Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
• Neurosurgery. 2018 Feb 1; 82 (2): 185-191.

BackgroundThough endovascular techniques and procedural devices continue to advance, recurrence of embolized aneurysms is still problematic. Enlarging size during follow-up is the presumed basis of recanalization in some lesions, but such growth has not been adequately investigated.ObjectiveTo generate estimates of growth in coiled aneurysms with major recanalization, focusing on incidence and risk factors involved.MethodsA cohort of 134 patients harboring 139 aneurysms were retrospectively reviewed, each subjected to re-embolization for major recanalization after initial coil embolization. Cumulative medical records and radiological data were assessed. The aneurysms were grouped by nature of recanalization, either related or unrelated to growth. Growth was defined as >50% increase in aneurysm volume (including coil mass) at the time of re-embolization, compared initial status. Aneurysm volumes were determined by volume of coil mass within full confines of the aneurysm. Univariate and multivariate analyses were performed to identify risk factors predisposing to growth.ResultsMajor recanalization was growth related in 74 coiled aneurysms (53.2%) and unrelated to growth (by coil compaction) in 65 (46.8%). Multiple logistic regression analysis indicated that growth of coiled aneurysm was linked to aneurysms initially ruptured at presentation (P = .002) and aneurysm size <7 mm (P < .001). Cumulative growth rates were as follows: 14 (18.9%), 6 mo; 18 (24.3%), 12 mo; 13 (17.6%), 24 mo; 10 (13.5%), 36 mo; and 19 (25.7%), >36 mo.ConclusionOur data suggest that aneurysms presenting with hemorrhage and small-sized aneurysms (<7 mm) are predisposed major recanalization by growth after coil embolization, as opposed to coil compaction.© Congress of Neurological Surgeons 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

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