Intracranial aneurysms treated with Guglielmi detachable coils: long-term imaging follow-up with contrast-enhanced magnetic resonance angiography

J Neurosurg. 2008 Mar;108(3):443-9. doi: 10.3171/JNS/2008/108/3/0443.


Object: The aim of this study was to assess the long-term results of intracranial aneurysms treated with Guglielmi detachable coils (GDCs) with the aid of contrast-enhanced magnetic resonance (MR) angiography.

Methods: Between January 1998 and August 2001, 92 patients with 92 aneurysms treated by endovascular coiling with GDCs underwent contrast-enhanced MR angiography. These patients underwent long-term follow-up (range 32-78 months, mean 42.1 +/- 11.9 months [standard deviation]) after endovascular treatment. All images were compared with digital subtraction angiograms and contrast-enhanced MR angiograms that had been obtained during the short-term follow-up (range 5-25 months, mean 13 +/- 5.1 months after treatment). The MR angiograms were analyzed independently by 2 senior radiologists. Findings were assigned to 1 of 3 categories: complete obliteration (Class 1), residual neck (Class 2), or residual aneurysm (Class 3).

Results: Of 92 contrast-enhanced MR angiograms obtained at the long-term follow-up, complete obliteration of the aneurysm was noted in 57 patients (Class 1), a residual neck was seen in 22 (Class 2), and a residual aneurysm was observed in 13 (Class 3). One patient experienced aneurysm rehemorrhaging during the follow-up period. The comparison of short- and long-term follow-up angiograms demonstrated a change in aneurysm classification in 7 patients (7.6%), including 4 that progressed from Class 1 to Class 2 and 3 from Class 2 to Class 3. However, 4 (14.2%) of the 28 long-term recurrences were not detected on the short-term control images.

Conclusions: Long-term follow-up with contrast-enhanced MR angiography after selective embolization of intracranial aneurysms can identify late aneurysm recanalization that is undetected at short-term follow-up.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Angioplasty*
  • Contrast Media
  • Embolization, Therapeutic / instrumentation*
  • Female
  • Follow-Up Studies
  • Gadolinium DTPA
  • Humans
  • Intracranial Aneurysm / diagnosis*
  • Intracranial Aneurysm / therapy*
  • Magnetic Resonance Angiography*
  • Male
  • Middle Aged
  • Recurrence
  • Subarachnoid Hemorrhage / diagnosis
  • Subarachnoid Hemorrhage / etiology
  • Subarachnoid Hemorrhage / therapy
  • Time Factors
  • Treatment Outcome


  • Contrast Media
  • gadodiamide
  • Gadolinium DTPA