Late recanalization of adequately coiled intracranial aneurysms 121 Table 2. Patient- and aneurysm characteristics of all participants in the multicenter study (left column) and of patients with aneurysm recanalization (middle column). 400 patients/ 11 patients/ OR (95% CI), p 440 aneurysms 11 aneurysms with long-term with aneurysm MRA follow-up reopening Women 276 (69%) 10 (91%) 4.66 (0.59 - 36.82), 0.14 Ruptured aneurysms 344 (78%) 9 (81%) 1.26 (0.27 - 5.94), 0.77 Size ш10 mm 66 (15%) 5 (45%) * 5.13 (1.52 - 17.32), 0.01‡ Posterior circulation 113 (26%) 5 (45%) † 2.51 (0.75 - 8.38), 0.14 Basilar tip 61 4 † 3.73 (1.06 - 13.14), 0.04‡ MRA: Magnetic Resonance Angiography; OR: Odds Ratio; ACA: anterior cerebral artery; MCA: middle cerebral artery; ICA: internal carotid artery. * For calculation of OR for aneurysm reopening of aneurysms ш10 mm, aneurysms <10 mm were used as reference group. † For calculation of OR for aneurysm reopening of posterior circulation aneurysms, anterior circulation aneurysms were used as reference group. For calculation of OR for aneurysm reopening of basilar tip aneurysms, aneurysms on all other locations were used as reference group. ‡ StaƟƐƟcally signiĮcant None of the three aneurysms with late recanalization were subjected to re-coiling (0.0%, 95% CI 0.0-6.4%). Two patients with aneurysm recanalization refused retreatment. In both patients a recanalization of the aneurysm had already been seen at the 24 month follow-up study, and the late follow-up study showed a very subtle enlargement of the recanalization (Figure 2 and 3). In the third patient, an interval follow-up MRA, performed 4.5 years after coiling, had still shown complete occlusion of the aneurysm. The late follow-up MRA that was done for this study, 9 years after the coiling procedure, showed a small recanalization at the wall of the aneurysm (Figure 4). In a multidisciplinary conference retreatment of the aneurysm was considered not indicated (Table 3). A B
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