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Neuroradiology |
1 From the Departments of Radiology (M.S., W.J.v.R., M.J.S.) and Neurosurgery (D.W.), St Elisabeth Ziekenhuis, Hilvarenbeekseweg 60, 5022 GC Tilburg, the Netherlands; and Department of Electrical Engineering, Mathematics and Computer Science, University of Twente, the Netherlands (J.O.B., C.H.S.). Received March 24, 2003; revision requested May 28; final revision received October 6; accepted November 20. Address correspondence to M.S. (e-mail: radiol@knmg.nl).
PURPOSE: To assess the relation between aneurysm volume, packing, and compaction in cerebral aneurysms treated with coils.
MATERIALS AND METHODS: The volumes of 145 aneurysms that were treated with coils were calculated with biplanar angiographic images and a custom-designed method. Partially thrombosed aneurysms were excluded. Packing was defined as the ratio between the volume of the inserted coils and the volume of the aneurysm and was calculated for all 145 aneurysms. Results at 6-month follow-up angiography were dichotomized into presence or absence of compaction.
RESULTS: Aneurysm volume, packing, and compaction at 6-month follow-up were closely related. Large aneurysm volume was associated with low packing and frequent compaction. High packing prevents compaction. If the aneurysm volume was packed for 24% or more with coils, compaction did not occur in aneurysms with a volume of less than 600 mm3. In small aneurysms with volumes of less than 200 mm3, compaction did not occur when packing was above 20%.
CONCLUSION: The common practice of inserting as many coils as possible in cerebral aneurysms is sensible in trying to avoid compaction. In aneurysms with packing of 24% or more, no compaction occurred at 6-month angiographic follow-up. In aneurysms with a volume of more than 600 mm3, high packing could not be achieved, which resulted in compaction in the majority of aneurysms.
© RSNA, 2004
Index terms: Aneurysm, cerebral, 17.38 • Aneurysm, therapy, 17.1269
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