Endovascular Treatment of Small Ruptured Intracranial Aneurysms (<5 mm) : Long-term Clinical and Angiographic Outcomes and Related Predictors.
PURPOSE
To investigate the long-term clinical and angiographic outcomes and their related predictors in endovascular treatment (EVT) of small (<5 mm) ruptured intracranial aneurysms (SRA).


METHODS
The study retrospectively reviewed patients with SRAs who underwent EVT between September 2011 and December 2016 in two Chinese stroke centers. Medical charts and telephone call follow-up were used to identify the overall unfavorable clinical outcomes (OUCO, modified Rankin score ≤2) and any recanalization or retreatment. The independent predictors of OUCO and recanalization were studied using univariate and multivariate analyses. Multivariate Cox proportional hazards models were used to identify the predictors of retreatment.


RESULTS
In this study 272 SRAs were included with a median follow-up period of 5.0 years (interquartile range 3.5-6.5 years) and 231 patients with over 1171 aneurysm-years were contacted. Among these, OUCO, recanalization, and retreatment occurred in 20 (7.4%), 24 (12.8%), and 11 (7.1%) patients, respectively. Aneurysms accompanied by parent vessel stenosis (AAPVS), high Hunt-Hess grade, high Fisher grade, and intraoperative thrombogenesis in the parent artery (ITPA) were the independent predictors of OUCO. A wide neck was found to be a predictor of recanalization. The 11 retreatments included 1 case of surgical clipping, 6 cases of coiling, and 4 cases of stent-assisted coiling. A wide neck and AAPVS were the related predictors.


CONCLUSION
The present study demonstrated relatively favorable clinical and angiographic outcomes in EVT of SRAs in long-term follow-up of up to 5 years. THE AAPVS, as a morphological indicator of the parent artery for both OUCO and retreatment, needs further validation.
['Peng|Fei|F|', 'Feng|Xin|X|', 'Tong|Xin|X|', 'Zhang|Baorui|B|', 'Wang|Luyao|L|', 'Guo|Erkang|E|', 'Qi|Peng|P|', 'Lu|Jun|J|', 'Wu|Zhongxue|Z|', 'Wang|Daming|D|', 'Liu|Aihua|A|']
D017542:Aneurysm, Ruptured D002533:Cerebral Angiography D004621:Embolization, Therapeutic D057510:Endovascular Procedures D005260:Female D005500:Follow-Up Studies D006801:Humans D002532:Intracranial Aneurysm D008875:Middle Aged D012189:Retrospective Studies D015607:Stents D016896:Treatment Outcome
Treatment Intracranial aneurysms Retreatment Angiography Risk factors