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Follow up of coiled intracranial aneurysms 111 Conclusion The aim of the present study was to evaluate the diagnostic performance of CEMRA in the follow-up of cerebral aneurysms treated by endovascular coiling. The results are not better than those reported in studies employing TOF-MRA, but they do support the conclusion drawn by Schaafsma et al. that MRA can be used for the follow-up of coiled aneurysms.19 The high NPV warrants a confident exclusion of recanalization with MRA. But, as a consequence of the low PPV, additional DSA may be necessary in case of incomplete occlusion seen on CEMRA, to assess whether repeat treatment is necessary. References 1 Bradac, O., Hide, S., Mendelow, D. A. & Benes, V. Aneurysm treatment in Europe 2010: an internet survey. Acta Neurochir (Wien) 154, 971-978, (2012). 2 Cognard, C., Pierot, L., Anxionnat, R. & Ricolfi, F. Results of embolization used as the first treatment choice in a consecutive nonselected population of ruptured aneurysms: clinical results of the Clarity GDC study. Neurosurgery 69, 837-841; discussion 842, (2011). 3 Smith, G. A., Dagostino, P., Maltenfort, M. G., Dumont, A. S. & Ratliff, J. K. Geographic variation and regional trends in adoption of endovascular techniques for cerebral aneurysms. J Neurosurg 114, 1768-1777, (2011). 4 Spiotta, A. M., Hui, F. K. & Moskowitz, S. I. Trends in device-assisted aneurysm treatment at a single high- volume tertiary care center. J Neurointerv Surg, (2012). 5 Johnston, S. C. et al. Predictors of rehemorrhage after treatment of ruptured intracranial aneurysms: the Cerebral Aneurysm Rerupture After Treatment (CARAT) study. Stroke 39, 120-125, (2008). 6 Ferns, S. P. et al. Coiling of intracranial aneurysms: a systematic review on initial occlusion and reopening and retreatment rates. Stroke 40, e523-529, (2009). 7 Murayama, Y. et al. Guglielmi detachable coil embolization of cerebral aneurysms: 11 years' experience. J Neurosurg 98, 959-966, (2003). 8 Raja, P. V. et al. Microsurgical clipping and endovascular coiling of intracranial aneurysms: a critical review of the literature. Neurosurgery 62, 1187-1202; discussion 1202-1183, (2008). 9 Sluzewski, M., van Rooij, W. J., Rinkel, G. J. & Wijnalda, D. Endovascular treatment of ruptured intracranial aneurysms with detachable coils: long-term clinical and serial angiographic results. Radiology 227, 720-724, (2003). 10 Campi, A. et al. Retreatment of ruptured cerebral aneurysms in patients randomized by coiling or clipping in the International Subarachnoid Aneurysm Trial (ISAT). Stroke 38, 1538-1544, (2007). 11 Fifi, J. T. et al. Complications of modern diagnostic cerebral angiography in an academic medical center. J Vasc Interv Radiol 20, 442-447, (2009). 12 Kaufmann, T. J. et al. Complications of diagnostic cerebral angiography: evaluation of 19,826 consecutive patients. Radiology 243, 812-819, (2007). 13 Kwee, T. C. & Kwee, R. M. MR angiography in the follow-up of intracranial aneurysms treated with Guglielmi detachable coils: systematic review and meta-analysis. Neuroradiology 49, 703-713, (2007). 14 Weng, H. H., Jao, S. Y., Yang, C. Y. & Tsai, Y. H. Meta-analysis on Diagnostic Accuracy of MR Angiography in the Follow-Up of Residual Intracranial Aneurysms Treated with Guglielmi Detachable Coils. Interv Neuroradiol 14 Suppl 2, 53-63, (2008). 15 Ferre, J. C. et al. Time-of-flight MR angiography at 3T versus digital subtraction angiography in the imaging follow-up of 51 intracranial aneurysms treated with coils. Eur J Radiol 72, 365-369, (2009). 16 Kaufmann, T. J. et al. A prospective trial of 3T and 1.5T time-of-flight and contrast-enhanced MR angiography in the follow-up of coiled intracranial aneurysms. AJNR Am J Neuroradiol 31, 912-918, (2010). 17 Lavoie, P. et al. Residual flow after cerebral aneurysm coil occlusion: diagnostic accuracy of MR angiography. Stroke 43, 740-746, (2012). 18 Pierot, L., Portefaix, C., Boulin, A. & Gauvrit, J. Y. 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).


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