Fellows’ Journal Club
Editor’s Comment
Clinical follow-up of 144 of 154 patients who survived the admission period (January 1995–August 2006) was for a mean of 9.8 years. Aneurysm size of 15 mm was the most important independent predictor for retreatment. Nine rebleeds occurred in 106 patients who initially presented with SAH after a median follow-up of 8.3 years. Eight patients died of aneurysm-related adverse events: 3 of rebleed and 5 of progressive mass effect. Life-long MRA follow-up at yearly intervals is recommended.
Abstract
BACKGROUND AND PURPOSE
Long-term follow-up data of coiled basilar tip aneurysms are scarce, and little is known about the risk of late aneurysm-related adverse events. We followed a cohort of 154 patients with basilar tip aneurysms coiled between 1995 and 2006.
MATERIALS AND METHODS
Imaging and clinical data were retrospectively reviewed. The incidence and timing of retreatment, rebleeds, and progressive mass effect by continuous aneurysm growth were recorded. Risk factors for retreatment were assessed.
RESULTS
Clinical follow-up of 144 of 154 patients who survived the admission period was a mean of 9.8 years (median, 10.2; range, 0.3–20.1 years). During this period, 37 basilar tip aneurysms (26%) were additionally coiled (annual incidence rate, 2.6%; 95% CI, 1.8%–3.6%). Aneurysm size of >15 mm was the most important independent predictor for retreatment (OR, 8.7; 95% CI, 3.4–22.5). The first additional coiling was performed in the first year of follow-up in 17 of 37 patients (46%) and in 20 patients (54%) at a later time up to 17.2 years. Nine rebleeds occurred in 9 of 106 patients who initially presented with SAH after a median follow-up of 8.3 years (range, 0.3–16.6 years). The annual incidence rate was 0.7% (95% CI, 0.4%–1.5%). Eight patients died of aneurysm-related adverse events: 3 of rebleed and 5 of progressive mass effect.
CONCLUSIONS
Retreatment of coiled basilar tip aneurysms was frequently needed during follow-up, also at long intervals. Most late mortality was from progressive mass effect, not from rebleeds. Life-long MRA follow-up at yearly intervals is recommended.
Read this article: http://bit.ly/CoiledBasilarTipAneurysms
