Clinical and Angiographic Outcome Predictors of Cerebral Aneurysms Treated with Endovascular Coil Embolization

Background: Endovascular coiling of Cerebral Aneurysms (CA) has been showing exponential growth over the last decades. Currently, aneurysmal coiling, either assisted or alone, constitutes the vast majority of all Endovascular Treatment (EVT) modalities for CA treatment.
Objectives: The authors aimed to assess the outcome and its predictors as well as aneurysm characteristics for patients with CA after endovascular coil embolization.
Methods: Patients with CA who have been treated with endovascular coiling were recruited from two centers and have their medical records retrospectively reviewed and analyzed. Clinical outcome was assessed using the modified Rankin Scale (mRS) 6 months & 1 year after coiling, while Raymond scale was used for Angiographic outcome assessment.
Results: A total of 38 patients (harboring 38 CA) were included in this study. Ruptured aneurysms constitute 60.53 % of all aneurysms. Seventy-four percent of ruptured CA were having a size of < 7 mm, while 83.3% of aneurysms < 5 mm were found ruptured with a trend of smaller-sized aneurysms to rupture. Simple coiling was utilized in 39.47 % of cases. Aspect ratio >1.6 was associated with ruptured status (p-value 0.006). Of ruptured aneurysms, 11 out of 13 ended up requiring retreatment (P-value 0.028). Favorable clinical outcomes were 65.8 % and 68.4 % at the 6 months and 1-year post coiling respectively.
Conclusion: Initial incomplete aneurysm occlusion and ruptured status were predictors of recurrence and retreatment. Aneurysm size and aspect ratio have a significant association with aneurysm rupture. The majority of ruptured CA were small ones.