Different factors influence recanalisation rate after coiling in ruptured and unruptured intracranial aneurysms

CNS Neurol Disord Drug Targets. 2013 Mar;12(2):228-32. doi: 10.2174/18715273112119990055.


Background: Most studies evaluating long-term efficacy after coil embolisation of intracranial aneurysms have not differentiated between ruptured and unruptured aneurysms.

Objectives: The aim of this study was to analyse factors that influence recanalisation in ruptured and unruptured aneurysms.

Methods: We performed a retrospective analysis of 182 (98 ruptured, 84 unruptured) aneurysms, treated with coil embolisation alone that received follow-up with digital substraction angiography (DSA).

Results: At 6 months 26% of the aneurysms showed recanalisation. Multivariate variance analysis revealed that different factors influenced recanalisation in ruptured and unruptured aneurysms. In ruptured aneurysms patient age was a determinant, with younger patients recanalising more frequently than older ones (p = 0.016). Also, low initial packing density led to higher recanalisation rates (p = 0.015) than higher packing. In the unruptured aneurysm group these factors were not significant. Here, only a larger aneurysm volume led to higher recanalisation rates (p = 0.027).

Conclusions: Our data suggest that in ruptured aneurysms, high packing density is a key factor to prevent recanalisation, while in unruptured aneurysms, aneurysm volume is the main predictor for recanalisation.

MeSH terms

  • Aneurysm, Ruptured / surgery*
  • Angiography, Digital Subtraction
  • Embolization, Therapeutic / instrumentation*
  • Embolization, Therapeutic / methods*
  • Female
  • Humans
  • Intracranial Aneurysm / surgery*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Retrospective Studies
  • Statistics, Nonparametric
  • Surgical Instruments
  • Treatment Outcome