Does angiographic surveillance pose a risk in the management of coiled intracranial aneurysms? A multicenter study of 2243 patients

Andrew J. Ringer, Giuseppe Lanzino, Erol Veznedaroglu, Rafael Rodriguez, Robert A. Mericle, Elad I. Levy, Ricardo A. Hanel, Demetrius K. Lopes, Alan S. Boulos

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

OBJECTIVE: Endovascular treatment of intracranial aneurysms is a less invasive alternative than surgical repair. However, the higher risk of recurrence after coiling necessitates regular angiographic surveillance, which has associated risks. To date, the risk of surveillance angiography has not been quantified in patients with intracranial aneurysms treated by endovascular embolization. METHODS: Angiograms performed for the surveillance of coiled intracranial aneurysms in patients treated at 8 institutions were recorded prospectively. Of 3086 patients eligible for surveillance angiography according to each institution's protocol during the study period, 2243 patients (72.7%) underwent this procedure. Data were reviewed retrospectively, including the results of each angiogram, angiographic complications, and morbidity resulting from the procedure. Morbidity was classified as major (modified Rankin Scale score ≥3) or minor (modified Rankin Scale score <3) and as temporary (<30 days) or permanent (≥30 days). RESULTS: Of 2814 diagnostic angiograms performed, 12 resulted in complications, including 1 (0.04%) permanent major morbidity, 2 (0.07%) temporary major morbidities, and 9 (0.32%) temporary minor morbidities; 6 of these were access site complications). No mortality or permanent minor morbidity was noted. CONCLUSION: in this study, routine angiographic surveillance after endovascular treatment of aneurysms has a very low complication rate (0.43%). Incorporating these initial findings with the rate and risk of recurrent treatment or the risk of hemorrhage after coiling will provide a more accurate estimate of the global long-term risk of aneurysm coiling.

Original languageEnglish (US)
Pages (from-to)845-848
Number of pages4
JournalNeurosurgery
Volume63
Issue number5
DOIs
StatePublished - Nov 2008
Externally publishedYes

Fingerprint

Risk Management
Intracranial Aneurysm
Multicenter Studies
Angiography
Morbidity
Aneurysm
Therapeutics
Hemorrhage
Recurrence
Mortality

Keywords

  • Aneurysm
  • Angiography
  • Coiling
  • Follow-up
  • Morbidity

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Ringer, A. J., Lanzino, G., Veznedaroglu, E., Rodriguez, R., Mericle, R. A., Levy, E. I., ... Boulos, A. S. (2008). Does angiographic surveillance pose a risk in the management of coiled intracranial aneurysms? A multicenter study of 2243 patients. Neurosurgery, 63(5), 845-848. https://doi.org/10.1227/01.NEU.0000333261.63818.9C

Does angiographic surveillance pose a risk in the management of coiled intracranial aneurysms? A multicenter study of 2243 patients. / Ringer, Andrew J.; Lanzino, Giuseppe; Veznedaroglu, Erol; Rodriguez, Rafael; Mericle, Robert A.; Levy, Elad I.; Hanel, Ricardo A.; Lopes, Demetrius K.; Boulos, Alan S.

In: Neurosurgery, Vol. 63, No. 5, 11.2008, p. 845-848.

Research output: Contribution to journalArticle

Ringer, AJ, Lanzino, G, Veznedaroglu, E, Rodriguez, R, Mericle, RA, Levy, EI, Hanel, RA, Lopes, DK & Boulos, AS 2008, 'Does angiographic surveillance pose a risk in the management of coiled intracranial aneurysms? A multicenter study of 2243 patients', Neurosurgery, vol. 63, no. 5, pp. 845-848. https://doi.org/10.1227/01.NEU.0000333261.63818.9C
Ringer, Andrew J. ; Lanzino, Giuseppe ; Veznedaroglu, Erol ; Rodriguez, Rafael ; Mericle, Robert A. ; Levy, Elad I. ; Hanel, Ricardo A. ; Lopes, Demetrius K. ; Boulos, Alan S. / Does angiographic surveillance pose a risk in the management of coiled intracranial aneurysms? A multicenter study of 2243 patients. In: Neurosurgery. 2008 ; Vol. 63, No. 5. pp. 845-848.
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abstract = "OBJECTIVE: Endovascular treatment of intracranial aneurysms is a less invasive alternative than surgical repair. However, the higher risk of recurrence after coiling necessitates regular angiographic surveillance, which has associated risks. To date, the risk of surveillance angiography has not been quantified in patients with intracranial aneurysms treated by endovascular embolization. METHODS: Angiograms performed for the surveillance of coiled intracranial aneurysms in patients treated at 8 institutions were recorded prospectively. Of 3086 patients eligible for surveillance angiography according to each institution's protocol during the study period, 2243 patients (72.7{\%}) underwent this procedure. Data were reviewed retrospectively, including the results of each angiogram, angiographic complications, and morbidity resulting from the procedure. Morbidity was classified as major (modified Rankin Scale score ≥3) or minor (modified Rankin Scale score <3) and as temporary (<30 days) or permanent (≥30 days). RESULTS: Of 2814 diagnostic angiograms performed, 12 resulted in complications, including 1 (0.04{\%}) permanent major morbidity, 2 (0.07{\%}) temporary major morbidities, and 9 (0.32{\%}) temporary minor morbidities; 6 of these were access site complications). No mortality or permanent minor morbidity was noted. CONCLUSION: in this study, routine angiographic surveillance after endovascular treatment of aneurysms has a very low complication rate (0.43{\%}). Incorporating these initial findings with the rate and risk of recurrent treatment or the risk of hemorrhage after coiling will provide a more accurate estimate of the global long-term risk of aneurysm coiling.",
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T1 - Does angiographic surveillance pose a risk in the management of coiled intracranial aneurysms? A multicenter study of 2243 patients

AU - Ringer, Andrew J.

AU - Lanzino, Giuseppe

AU - Veznedaroglu, Erol

AU - Rodriguez, Rafael

AU - Mericle, Robert A.

AU - Levy, Elad I.

AU - Hanel, Ricardo A.

AU - Lopes, Demetrius K.

AU - Boulos, Alan S.

PY - 2008/11

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N2 - OBJECTIVE: Endovascular treatment of intracranial aneurysms is a less invasive alternative than surgical repair. However, the higher risk of recurrence after coiling necessitates regular angiographic surveillance, which has associated risks. To date, the risk of surveillance angiography has not been quantified in patients with intracranial aneurysms treated by endovascular embolization. METHODS: Angiograms performed for the surveillance of coiled intracranial aneurysms in patients treated at 8 institutions were recorded prospectively. Of 3086 patients eligible for surveillance angiography according to each institution's protocol during the study period, 2243 patients (72.7%) underwent this procedure. Data were reviewed retrospectively, including the results of each angiogram, angiographic complications, and morbidity resulting from the procedure. Morbidity was classified as major (modified Rankin Scale score ≥3) or minor (modified Rankin Scale score <3) and as temporary (<30 days) or permanent (≥30 days). RESULTS: Of 2814 diagnostic angiograms performed, 12 resulted in complications, including 1 (0.04%) permanent major morbidity, 2 (0.07%) temporary major morbidities, and 9 (0.32%) temporary minor morbidities; 6 of these were access site complications). No mortality or permanent minor morbidity was noted. CONCLUSION: in this study, routine angiographic surveillance after endovascular treatment of aneurysms has a very low complication rate (0.43%). Incorporating these initial findings with the rate and risk of recurrent treatment or the risk of hemorrhage after coiling will provide a more accurate estimate of the global long-term risk of aneurysm coiling.

AB - OBJECTIVE: Endovascular treatment of intracranial aneurysms is a less invasive alternative than surgical repair. However, the higher risk of recurrence after coiling necessitates regular angiographic surveillance, which has associated risks. To date, the risk of surveillance angiography has not been quantified in patients with intracranial aneurysms treated by endovascular embolization. METHODS: Angiograms performed for the surveillance of coiled intracranial aneurysms in patients treated at 8 institutions were recorded prospectively. Of 3086 patients eligible for surveillance angiography according to each institution's protocol during the study period, 2243 patients (72.7%) underwent this procedure. Data were reviewed retrospectively, including the results of each angiogram, angiographic complications, and morbidity resulting from the procedure. Morbidity was classified as major (modified Rankin Scale score ≥3) or minor (modified Rankin Scale score <3) and as temporary (<30 days) or permanent (≥30 days). RESULTS: Of 2814 diagnostic angiograms performed, 12 resulted in complications, including 1 (0.04%) permanent major morbidity, 2 (0.07%) temporary major morbidities, and 9 (0.32%) temporary minor morbidities; 6 of these were access site complications). No mortality or permanent minor morbidity was noted. CONCLUSION: in this study, routine angiographic surveillance after endovascular treatment of aneurysms has a very low complication rate (0.43%). Incorporating these initial findings with the rate and risk of recurrent treatment or the risk of hemorrhage after coiling will provide a more accurate estimate of the global long-term risk of aneurysm coiling.

KW - Aneurysm

KW - Angiography

KW - Coiling

KW - Follow-up

KW - Morbidity

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