Single centre experience of surgical and endovascular treatment 95 Table 6 shows the findings at follow-up imaging in aneurysms which had undergone endovascular treatment. Follow-up angiography was available for 181 surviving patients (95.3%, harboring 189 aneurysms). The average interval between treatment and the last angiographic follow-up was 29.1 months (range 4.8-102.8 months). Increasing compaction of the coil mass was observed in 72 aneurysms (38.1%); this occurred more often in the group that showed a residual aneurysm at the end of the procedure (52.0%) than in those with complete occlusion (36.8%) or a residual neck (34.0%) determined at post-procedural angiography. However, this difference was not statistically significant (p=0.124). Table 6. Angiographic FU after endovascular treatment by post-procedural angiographic results Increased Post procedural angiographic No changes Improvement recanalization results Number (%) Number (%) Number (%) Complete occlusion (n=114) 72 (63.2) - 42 (36.8) Residual neck (n=50) 24 (48.0) 9 (18.0) 17 (34.0) Residual aneurysm (n=25) 12 (48.0) - 13 (52.0) Total 189 108 (57.1) 9(4.8) 72 (38.1) Re-treatment was performed in 16 aneurysms in the endovascular group, 2 after rebleeding and 14 without rebleeding. At the end of the first procedure 10 of these showed a residual aneurysm, 4 aneurysms a residual neck, and 2 were completely occluded after coiling. Rebleeds After the procedure, rebleeding from the target aneurysm occurred in 12 aneurysms. Six (2.5%) occurred after endovascular treatment, and 6 (3.0%) after surgical treatment. This difference is not statistically significant (p=0.769). Four patients from the endovascular treatment group had a residual aneurysm shown by post- procedural imaging, and 2 had a residual neck. In the endovascular group the presence of a residual neck after coiling was not related to rebleeding (p=0.085). The presence of a residual aneurysm after coiling was statistically significantly related to rebleeding (p=0.001). One of the surgically treated patients mentioned above had a residual aneurysm; the other 5 did not undergo post-procedural angiography. Because of the missing data no analysis could be performed on the surgically treated aneurysms. Outcome of rebleeds was poor (Table 7).
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