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Endovascular therapy for aneurysms prevents long-term bleeding, may lead to recurrence
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Ten-year follow-up data indicate that endovascular treatment of intracranial aneurysms prevented long-term bleeding, but yielded elevated recurrence rates.
Researchers assessed long-term outcomes of endovascular treatment for intracranial aneurysms using data from two large cohort studies. Ten-year follow-up efficacy data were available for 110 of 1,036 (10.6%) aneurysm events and 57 of 1,063 (5.4%) patients. The current study includes a mean duration of clinical follow-up of 144.2 ± 18.6 months (interquartile range [IQR], 128-156 months).
There were 36 re-treated aneurysms. Of those events, 19.4% of re-treatments occurred within 1 year after endovascular treatment, 52.9% occurred between years 1 and 5, 19.4% occurred between years 5 and 10, and 8.3% occurred after 10 years.
Angiographic follow-up data were available for a mean of 61 ± 20 months (IQR, 36-51 months) and revealed 29 aneurysms. The majority of those events (81.9%) were grade 1 aneurysms.
The mean duration of long-term follow-up was 136 ± 20 months (IQR, 127-151 months). Data for 129 aneurysms with long-term follow-up available indicated that 56.6% were grade 1, 31% were grade 2 and 12.4% were grade 3.
Between midterm follow-up and long-term follow-up, 12.4% of 129 aneurysms were given a less favorable grade, according to the results. New aneurysms were reported in 9.8% of 112 patients with a mean follow-up duration of 133.2 ± 11 months (median, 134 months).
“[Endovascular therapy] of intracranial aneurysms is effective 10 years after treatment for prevention of long-term bleeding, but may be followed by recurrences in a clinically relevant percentage of cases,” the researchers concluded. “The typically recommended MR angiographic follow-up at 3 to 5 years is insufficient to detect many recurrences, and our results may justify a longer follow-up period in selected cases, such as for aneurysms larger than 10 mm, grade 2 aneurysms at 3- to 5-year follow-up MR angiography, and aneurysms requiring retreatment within 5 years.” – by Rob Volansky
Disclosure: The researchers report no relevant financial disclosures.
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