The ability of plain radiography to predict intracranial aneurysm occlusion instability during follow-up of endosaccular treatment with Gugliemi detachable coils
Sej. Connor et al., The ability of plain radiography to predict intracranial aneurysm occlusion instability during follow-up of endosaccular treatment with Gugliemi detachable coils, NEURORADIOL, 43(8), 2001, pp. 680-686
Incomplete occlusion of an intracranial aneurysm at followup after treatmen
t with Gugliemi detachable coils (GDC) increases the risk of rebleeding and
serial angiographic monitoring is therefore currently indicated. We aimed
to determine if a change in the plain radiographic appearances of the GDC b
all could accurately predict the presence of unstable angiographic occlusio
n. Paired GDC radiographs (in two planes) and cerebral angiograms, performe
d immediately after treatment and at follow-up or at two consecutive follow
-up examinations, were retrospectively compared. Radiographs were assessed
for the radiographic change (loosening, compaction or reorientation) in the
coil-ball and angiograms for unstable aneurysm occlusion (neck recurrence
or deteriorating occlusion). We compared 49 paired films from 38 patients.
Radiographic change in the coil ball had a negative predictive value of 96
%, positive predictive value of 57 % and accuracy of 76 % for the presence
of angiographic aneurysm instability. It may be possible to increase the in
terval between followup angiographic examinations after GDC treatment safel
y if there is no change in the radiographic appearances in two planes.