Published online before print May 29, 2003, doi: 10.1161/01.STR.0000073841.88563.E9
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Stroke. 2003;34:1398.)
© 2003 American Heart Association, Inc.
Original Contributions |
Long-Term Angiographic Recurrences After Selective Endovascular Treatment of Aneurysms With Detachable Coils
From the Department of Radiology (J.R., F.G., A.W., S.A.G., L.J., D.R.), Centre Hospitalier de l’Université de Montréal (CHUM), Notre-Dame Hospital, and the Research Center of CHUM ( J.R., A.L., J.L.) and the Department of Mathematics and Statistics, University of Montreal (M.C.), Montreal, Canada.
Correspondence to Jean Raymond, MD, Interventional Neuroradiology Research Laboratory, Centre Hospitalier de l’Université de Montréal (CHUM), Notre-Dame Hospital, 1560 Sherbrooke East, Room M-8203-1, Montreal, Quebec, H2L 4M1, Canada. E-mail dr_jean_raymond{at}hotmail.com
 |
Abstract |
|---|
 Top Abstract IntroductionMaterials and MethodsResultsDiscussionReferences |
|---|
Background and Purpose— Our aim in this study was to assess the incidence and determining factors of angiographic recurrences after endovascular treatment of aneurysms.
Methods— A retrospective analysis of all patients with selective endosaccular coil occlusion of intracranial aneurysms prospectively collected from 1992 to 2002 was performed. There were 501 aneurysms in 466 patients (mean±SD age, 54.20±12.54 years; 74% female). Aneurysms were acutely ruptured (54.1%) or unruptured (45.9%). Mean±SD aneurysm size was 9.67±5.91 mm with a 4.31±1.97-mm neck. The most frequent sites were basilar bifurcation (27.7%) and carotid ophthalmic (18.0%) aneurysms. Recurrences were subjectively divided into minor and major (ideally necessitating re-treatment). The most significant predictors of angiographic recurrence were determined by logistic regression. These results were confirmed by 
2, t tests, or ANOVAs followed, when appropriate, by Tukey’s contrasts.
Results— Short-term (
1 year) follow-up angiograms were available in 353 aneurysms (70.5%) and long-term (>1 year) follow-up angiograms, in 277 (55%), for a total of 383 (76.5%) followed up. Recurrences were found in 33.6% of treated aneurysms that were followed up and that appeared at a mean±SD time of 12.31±11.33 months after treatment. Major recurrences presented in 20.7% and appeared at a mean of 16.49±15.93 months. Three patients (0.8%) bled during a mean clinical follow-up period of 31.32±24.96 months. Variables determined to be significant predictors (P<0.05) of a recurrence included aneurysm size 
10 mm, treatment during the acute phase of rupture, incomplete initial occlusions, and duration of follow-up.
Conclusions— Long-term monitoring of patients treated by endosaccular coiling is mandatory.
Key Words: endovascular therapy • intracranial aneurysm • recurrence
|
Introduction |
|---|
|
TopAbstractIntroductionMaterials and MethodsResultsDiscussionReferences |
|---|
Endovascular treatment has proven effective in preventing rebleeding after subarachnoid hemorrhage due to aneurysmal rupture.1–3 A randomized study comparing endovascular and surgical management of ruptured aneurysms has shown significantly improved outcomes in patients treated with coils.4 The management of unruptured aneurysms is still controversial.5–8 Endovascular treatment is less invasive, but whether this evidence translates into better long-term outcome than surgical or conservative management remains to be proven.7
The respective roles of endovascular and surgical treatment of aneurysms remain unclear, and various options are offered to patients in different countries or institutions. There is, however, no doubt that aneurysm rests and recurrences are more frequent after endovascular treatment than after surgical clipping. The magnitude and clinical significance of this important drawback of endovascular treatment are still poorly documented, because most series have followed up only a limited number of patients for relatively short periods.9–13 Emerging new embolic agents or devices might increase long-term efficacy, possibly at the cost of increased immediate complications, and there might be a need to identify a target population with lesions at higher risk of recurrence or a subpopulation of patients in whom recurrences are unlikely. We have prospectively collected all cases treated by endovascular treatments since our first patients in 1992. Because our population is sedentary and health care is provided by a universal program, we had a unique occasion to follow the evolution of treated aneurysms in a large proportion of patients for many years. We attempted to identify the risk factors that were significantly associated with angiographic recurrences after selective endovascular treatment of aneurysms.
|
Materials and Methods |
|---|
|
TopAbstractIntroductionMaterials and MethodsResultsDiscussionReferences |
|---|
Patients and Aneurysms
The present study included all subarachnoid aneurysms treated at our institution by endosaccular coiling with detachable coils (Guglielmi, GDC, Target Therapeutics). There were no strict inclusion criteria. Patients were referred from neurosurgical centers for lesions that were judged to be difficult for surgical treatment, after failed surgical attempts, or after a consensus was reached between the attending neurosurgeon and neuroradiologist in favor of endovascular treatment over surgery or a conservative approach. Whenever possible, large and giant lesions were treated by parent-vessel occlusion, and these were excluded from analysis, unless this strategy was used after a recurrence, in which case the period of follow-up before the second treatment was included. Demographic data included age, sex, history of previous subarachnoid hemorrhage, previous surgery for aneurysms, treatment during the acute phase after subarachnoid hemorrhage, and Hunt and Hess grades at the time of treatment. Aneurysmal characteristics included the ruptured/unruptured nature of the lesion, long axis, short axis, neck size, and location.
We treated 501 aneurysms in 466 patients from August 1992 to May 2002, and 383 lesions in 356 patients were followed up at least once by angiography. The mean±SD age was 54.20±12.54 years, and 74% of patients were women. Patients had multiple aneurysms in 35.6% of cases, and 28.8% had been previously treated by surgery on the same (9%) or another lesion. Approximately half of the lesions (54.1%) were acutely ruptured at the time of treatment. The Hunt and Hess grades at the time of treatment in the ruptured group were grade I–II in 56%, grade III in 29%, and grade IV–V in 15%. Most frequents sites were basilar bifurcation (27.7%), ophthalmic carotid (18.0%), anterior (13.6%), and posterior communicating artery (11.2%) aneurysms. Only 6.8% of aneurysms were at the middle cerebral artery bifurcation. Aneurysmal dimensions were estimated by using the size of the first coil as a reference. Mean aneurysmal dimensions were 9.67±5.91 mm for the long axis, 7.23±4.44 mm for the short axis, and 4.31±1.97 mm for the neck width.
Endovascular Treatment
The technique for endovascular GDC treatment has been described previously.3,5 All procedures were performed on a monoplane C-arm angiographic system without 3-dimensional reconstruction. Most patients were treated under general anesthesia. Patients were treated once in 91.4% of cases, but 6.6% were treated twice and 2%, 3 or 4 times. Patients with a failure of coil embolization or after a major recurrence were treated with surgical clipping in 4.2% or by endovascular parent-vessel occlusion in 5.6%. They were then excluded from angiographic follow-up studies. Patients with major recurrences were most often re-treated with coiling (39/79, or 49%).
Angiographic Results
Angiographic follow-up studies were scheduled to be performed in all patients actually treated with coils at 6 months, and if the results were stable, for incremental periods (18 months, 3 years, etc). When a recurrence was found but the patient was considered protected from rebleeding or when, by clinical judgment, re-treatment was judged to be inappropriate, the next follow-up study was scheduled yearly thereafter. Multiple projections with selective injections served to define any residual lesions. Anatomic results were evaluated in a very strict fashion and classified as previously published.5 In brief, a class I result meant complete obliteration, including the neck. A residual neck (class 2) was defined as the persistence of any portion of the original defect of the arterial wall as seen on any single projection but without opacification of the aneurysmal sac. Any opacification of the sac was classified as residual aneurysm (class 3). When an aneurysm was considered occluded (class 1 or 2) at the end of treatment, despite minimal opacification artificially maintained by heparinization, the first angiographic follow-up result served as the "immediate result." This definition was used to minimize the number of aneurysms showing "improved results" at follow-up. A recurrence was defined as any increase in the size of the remnant. The recurrence was qualified as major if it was saccular and its size would theoretically permit re-treatment with coils. The number of months between treatment and the first follow-up angiogram showing the recurrence was noted. When a lesion first showed a "minor recurrence" but subsequent follow-up angiograms did not show any change, the number of months of "stability" of this minor recurrence was recorded. Short-term (1 year) follow-up angiograms were available in 353 aneurysms (70.5%) and long-term (>1 year) in 277 (55%), for a total of 383 (76.5%) followed up. Absence of angiographic follow-up was due to failure (4%), death (9.9%), patient lost to follow-up (2.6%), patient refusal (4.3%), and follow-up study planned but not yet performed (2.7%).
Clinical Follow-Up
Further clinical follow-up data were collected during hospitalization for follow-up angiography or by telephone interviews. The total number of months of clinical follow-up for each patient was recorded. The mean±SD clinical follow-up was 31.32±24.96 months. New neurologic episodes were also noted. Rebleeding episodes due to incomplete obliteration of aneurysms, occurring within 2 weeks of the initial subarachnoid episode that prompted treatment, were not included as recurrences.
Statistics
The most significant predictors of angiographic recurrence were determined by using logistic regression, 2 tests, ANOVAs (followed, when appropriate, by a Tukey’s contrast), or t tests. When 2 aneurysms were present in the same patient, they were considered independent for the purpose of statistical studies. Aneurysmal dimensions and time were studied as continuous variables. These variables were also analyzed by groups (aneurysms 10 mm, aneurysmal neck >4 mm).
Patients were also subdivided into 3 equal groups according to the duration of angiographic follow-up periods: group 1 included patients with 1 to 16 months of angiographic follow-up; group 2 were patients with 17 to 37 months; and group 3 were those with >37 months of angiographic follow-up.
|
Results |
|---|
|
TopAbstractIntroductionMaterials and MethodsResultsDiscussionReferences |
|---|
Angiographic Results
Most patients had 1 (34.0%) or 2 (29.3%) follow-up angiographic studies, but 36.7% had 3 to 10, for a total of 907 studies in 376 patients. Complications occurred in 3, or 0.3%, of studies (0.8% of patients). The initial short- and long-term angiographic results are summarized in Table 1. Twenty-one lesions treated by surgical clipping and 28 patients treated by parent-vessel occlusion after failure or recurrences were then excluded from follow-up tables. Some failures were followed up, whereas 39 patients with recurrences were re-treated with coiling during the follow-up period.
|
Recurrences
Recurrences were found in a total of 128 of 381, or 33.6%, of treated aneurysms at a mean of 12.31±11.33 months. Recurrences were shown to be minor and stable at further follow-up angiography for a mean of 33.60±25.60 months in 22.1% of cases. Major recurrences were found in 79 of 381, or 20.7%, of all patients and found at a mean of 16.49±15.93 months. Almost half (49.4%) of major recurrences were re-treated with coils, and 48.6% of those showed a second recurrence, which appeared after a mean follow-up of 15.56±18.43 months. Three patients (0.8%) experienced a bleeding episode during the follow-up period. These events occurred 13.25±8.62 months after treatment and were associated with angiographic recurrence of the treated lesion. One of these patients died despite re-treatment.
Factors Associated With Recurrences
Age (P=0.510), sex (P=0.374), and aneurysmal location had no significant influence on recurrences (P=0.259 for the most frequent sites). The rates of recurrence according to the most frequent locations are summarized in Table 2. According to 2 tests, the most significant predictors of a recurrence for the entire group were treatment during the acute phase after rupture (P=0.013), size of the aneurysm (P<0.001), width of the neck of the aneurysm (P<0.001), suboptimal initial angiographic result (class 2 or 3; P<0.001), and length of follow-up period (P=0.003).
|
Acutely Ruptured Aneurysms
Seventy-six of 191, or 39.8%, of aneurysms treated acutely after rupture and followed up recurred at least once, compared with 52 of 190, or 27.4%, of unruptured lesions (P=0.013). Major recurrences occurred in 48 (25.1%) and 31 (16.3%) aneurysms, respectively (P=0.043).
Aneurysm Size
There were strong correlations between aneurysmal dimensions. The larger the aneurysm, the wider the neck (r=0.681, P<0.001); there was also a strong correlation between short and long axes (r=0.920, P<0.001). Lesions 
10 mm in diameter had a significantly higher risk of recurrences (P<0.001). The relation between aneurysmal size and the incidence of recurrences is summarized in Table 3.
|
Neck Size
Aneurysms with necks wider than 4 mm had a significantly higher risk of developing a recurrence (P<0.001; Table 3). When patients were divided into groups according to the length of the follow-up period, aneurysm neck size had a strong impact on recurrences in patients who were followed up for >17 months (P=0.003) but not in patients who were followed up for 16 months or less (P=0.122). For all lesions, the size of the neck had a strong influence on initial angiographic results (P<0.001): 44.5% of aneurysms with small necks but only 20.2% of wide-necked lesions were completely obliterated (P<0.001).
Initial Angiographic Results
Lesions that were completely occluded with coils, without a residual neck, had a significantly lower risk of developing a recurrence (P<0.001). When patients were divided into 3 groups according to the length of the follow-up period, complete occlusions were at a lower risk of developing a recurrence in the first 2 groups (<17 months and 18 to 37 months; P=0.007), but initial angiographic results did not have a statistically significant impact on patients with the longest follow-up period (>37 months; P=0.200). The relation between initial angiographic results and recurrences is summarized in Table 4.
|
Length of Follow-Up Period
When patients were divided into 3 groups according to the length of angiographic follow-up, the group followed up for <17 months was at lesser risk of showing a recurrence (P=0.003) than the 2 groups followed up for 17 months or more. Results are summarized in Table 5.
|
The only significant predictor of a recurrence in the group followed up for 1 to 16 months was the initial angiographic result. When the lesion was completely obliterated, recurrences were less likely (P=0.002). For patients in the group followed up for 17 to 37 months, predictors of a recurrence included aneurysm size (P<0.001), neck size (P<0.001), and initial angiographic result (P<0.001). For patients followed up for >37 months, predictors included aneurysm size (P=0.003), neck size (P=0.003), and ruptured lesions (P=0.02). When we compared the characteristics of the first and the last 100 patients treated, there was no difference between the 2 groups, except that more recent patients tended to be older (mean±SD age, 55.87±13.17 vs 51.87±11.60 years; P=0.034). When the number of recurrences detected by 6 months was compared, there was no significant difference between the 3 groups of patients subdivided according to length of follow-up period. Another way of looking at the influence of the duration of the follow-up period on the incidence of recurrences is illustrated in Figure 1. Only 46.9% of all recurrences had been detected by 6 months. By 36 months, 96.9% of all recurrences detected in our population were diagnosed.
|
Logistic Regression Analysis
Significant factors predicting the risk of developing any type of recurrence and studied by logistic regression are summarized in Table 6. The effects of the width of the neck of aneurysms on recurrence did not reach statistical significance by this analysis (P=0.086)
|
|
Discussion |
|---|
|
TopAbstractIntroductionMaterials and MethodsResultsDiscussionReferences |
|---|
Angiographic recurrences after endovascular treatment of aneurysms are more common in large, ruptured lesions with suboptimal initial results and will be detected more frequently with long-term follow-up studies. Clearly, the 6-month follow-up angiographic study that is commonly recommended is insufficient to detect all recurrences.
Factors previously identified as significant predictors of a recurrence include suboptimal initial angiographic results, treatment after rupture, and aneurysm size.9–15 These risk factors have been confirmed in our study. We, as well as others, have not found a significant impact of location on recurrence, although this might be due to insufficient statistical power.12 The difference in the incidence of recurrences after treatment of unruptured and ruptured lesions cannot be explained by a difference in other factors, such as aneurysm size, neck width, or quality of initial angiographic result. There is a significant difference in the frequency of certain anatomic sites (overrepresentation of ophthalmic aneurysms in the unruptured group, for example) between the 2 groups, but we could not explain the dramatic increase in recurrences after treatment during the acute phase after rupture with this factor alone. One has to hypothesize that some biologic difference exists between the 2 groups.12
The magnitude of the recurrence problem will vary according to selection bias, as well as to the length of the follow-up period. Because endovascular treatment is increasingly being used, most series include a larger number of patients being followed up for short periods, compared with a smaller number of patients followed up for longer periods. Therefore, recurrence rates expressed as the ratio of cases showing a recurrence over total cases treated are artificially minimizing the magnitude of the problem. If we limit our evaluation to patients with long follow-up periods, the percentage of patients showing any recurrence is 40% (major in 24%). Because these patients were treated early in our experience, 1 hypothesis is that techniques have improved with time. This hypothesis might be supported by the finding that aneurysmal characteristics had no significant impact on recurrences in patients followed up for <17 months, a group in whom the initial angiographic result was the single, significant predictor of a recurrence. The more frequent use of advanced techniques, such as the balloon-assisted technique16 and the aneurysmal neck-bridge device,17 might have permitted us to achieve complete obliterations in large, wide-necked lesions previously associated with suboptimal results.14 Another hypothesis is that recurrences occur in a delayed fashion, according to characteristics that are intrinsic to the lesion. This second hypothesis is supported by the lesser impact of initial results on recurrences in groups followed up for >37 months, a group in whom the ruptured nature of the lesion, size of the neck, and lesion size had the strongest impact on recurrences. One interpretation is that complete obliteration of the lesion is important to decrease early recurrences, and this can be achieved more frequently with technical advances, but recurrences might still occur in a delayed fashion.
The characteristics of our population follow the common North American bias in the selection of patients referred for endovascular treatment, with a high proportion of lesions considered at higher risk for surgical clipping, such as basilar bifurcation or ophthalmic aneurysms.18,19 Another weakness of this study is that it was retrospective, and although patients were prospectively entered into the database, the frequency and intervals for angiographic follow-up studies, though somewhat standardized, were not systematic. The classification of angiographic results and the diagnosis of a recurrence are subjective evaluations that might differ from 1 center to another.9 We have chosen to distinguish "minor" from "major" recurrences. Minor changes from the initial or first follow-up angiogram can be detected objectively by a rigorous evaluation, but there might be concerns of increasing sensitivity of detection of recurrences at the expense of specificity by overcalling lesions that might show stability later on. The clinical significance of a nonprogressing residual neck, found in 22% of all recurrences, has not been determined with certainty, although it is probably not without hemorrhagic risks.20 Major recurrences are more definitely of concern. Patients who bled during follow-up were shown to have unstable results, with residual aneurysms that had progressed since the previous angiographic study.
One of the important objectives of this work was to identify patients who might benefit from an improved endovascular intervention, which might carry added risks,21,22 or patients in whom standard coil embolization might be sufficient. In our opinion, we have not identified a category of patient who would not benefit from the use of "improved" treatment, because the best aneurysmal characteristics, such as small size and a small neck, were still associated with a recurrence rate >20% (11% of major recurrences).
One important factor in the detection of recurrences was the length of the angiographic follow-up period. Clearly, the 6-month angiogram is insufficient to detect a majority of cases (only 48% of recurrences were detected). Although repeated angiographic studies carry their own risk, we believe that all patients should at least be followed up by noninvasive imaging studies, if not by angiography, for 36 months or more. The complications related to multiple angiograms were 0.3% in this study, a figure that is compatible with other published rates.23,24 Although patients who have already experienced recurrences have a high incidence of second recurrences (almost 50% so far), we often chose to treat recurrences by coiling, because surgical risks might be compounded by the presence of coils at the neck.25
Regarding current treatment options, as well as future modifications that might be proposed to improve long-term results of coil embolization, a question remains: how much risk is worth taking immediately to prevent a potential angiographic recurrence in the future? We have found a risk of bleeding in 0.8% of patients, for a mean period of observation of 31.3 months. Others have shown a hemorrhagic risk of the same magnitude.2,9–11 In the context of acutely ruptured lesions, for which endovascular treatment has proven effective in preventing rebleeding in the first 6 months, these risks of future hemorrhages are small compared with the immediate morbidity of the disease and of treatment.4 Endovascular treatment has proven to improve clinical outcome 1 year after treatment compared with surgical clipping.4 This benefit of the endovascular approach should not be negated by a more efficient though riskier treatment. Conversely, in unruptured aneurysms where there is no obvious immediate benefit, long-term efficacy might be essential to justify any intervention. Operative risks should nevertheless be very low, because the annual risk of rupture might be lower than we had previously hypothesized.5,26
Conclusions
Endovascular treatment with detachable coils is followed by angiographic recurrences in 33.6% of cases. These recurrences are sizable in 20.7%. The most important factors associated with recurrences are treatment after rupture, size >10 mm, and incomplete occlusions. The 6-month follow-up angiogram is insufficient to detect most recurrences.
|
Acknowledgments |
|---|
This work was supported in part by the Canadian Institutes of Health Research. We thank Rosemay Roy and Guylaine Gevry for assistance with the preparation of the manuscript.
Received December 18, 2002; accepted January 20, 2003.
|
References |
|---|
|
TopAbstractIntroductionMaterials and MethodsResultsDiscussionReferences |
|---|
1. Vinuela F, Duckwiler G, Mawad M. Guglielmi detachable coil embolization of acute intracranial aneurysm: perioperative anatomical and clinical outcome in 403 patients. J Neurosurg. 1997; 86: 475–482.[Medline] [Order article via Infotrieve]
2. Byrne JV, Sohn MJ, Molyneux AJ, Chir B. Five-year experience in using coil embolization for ruptured intracranial aneurysms: outcomes and incidence of late rebleeding. J Neurosurg. 1999; 90: 656–663.[Medline] [Order article via Infotrieve]
3. Raymond J, Roy D. Safety and efficacy of endovascular treatment of acutely ruptured aneurysms. Neurosurgery. 1997; 41: 1235–1245;discussion 1245–1246.
4. Molyneux A, Kerr R, Stratton I, Sandercock P, Clarke M, Shrimpton J, Holman R, International Subarachnoid Aneurysm Trial (ISAT) Collaborative Group. International Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised trial. Lancet. 2002; 360: 1267–1274.[CrossRef][Medline] [Order article via Infotrieve]
5. Roy D, Milot G, Raymond J. Endovascular treatment of unruptured aneurysms. Stroke. 2001; 32: 1998–2004.
6. Murayama Y, Vinuela F, Duckwiler GR, Gobin YP, Guglielmi G. Embolization of incidental cerebral aneurysms by using the Guglielmi detachable coil system. J Neurosurg. 1999; 90: 207–214.[Medline] [Order article via Infotrieve]
7. Johnston SC, Dudley RA, Gress DR, Ono L. Surgical and endovascular treatment of unruptured cerebral aneurysms at university hospitals. Neurology. 1999; 52: 1799–1805.
8. Bederson JB, Awad IA, Wiebers DO, Piepgras D, Haley EC Jr, Brott T, Hademenos G, Chyatte D, Rosenwasser R, Caroselli C. Recommendations for the management of patients with unruptured intracranial aneurysms: a statement for healthcare professionals from the Stroke Council of the American Heart Association. Stroke. 2000; 31: 2742–2750.
9. Thornton J, Debrun GM, Aletich VA, Bashir Q, Charbel FT, Ausman J. Follow-up angiography of intracranial aneurysms treated with endovascular placement of Guglielmi detachable coils. Neurosurgery. 2002; 50: 239–249;discussion 249–250.
10. Ng P, Khangure MS, Phatouros CC, Bynevelt M, ApSimon H, McAuliffe W. Endovascular treatment of intracranial aneurysms with Guglielmi detachable coils: analysis of midterm angiographic and clinical outcomes. Stroke. 2002; 33: 210–217.
11. Hayakawa M, Murayama Y, Duckwiler GR, Gobin YP, Guglielmi G, Vinuela F. Natural history of the neck remnant of a cerebral aneurysm treated with the Guglielmi detachable coil system. J Neurosurg. 2000; 93: 561–568.[Medline] [Order article via Infotrieve]
12. Cognard C, Weill A, Spelle L, Piotin M, Castaings L, Rey A, Moret J. Long-term angiographic follow-up of 169 intracranial berry aneurysms occluded with detachable coils. Radiology. 1999; 212: 348–356.
13. Cognard C, Weill A, Castaings L, Rey A, Moret J. Intracranial berry aneurysms: angiographic and clinical results after endovascular treatment. Radiology. 1998; 206: 499–510.
14. Fernandez Zubillaga A, Guglielmi G, Vinuela F, Duckwiler GR. Endovascular occlusion of intracranial aneurysms with electrically detachable coils: correlation of aneurysm neck size and treatment results. AJNR Am J Neuroradiol. 1994; 15: 815–820.[Abstract]
15. Tamatani S, Ito Y, Abe H, Koike T, Takeuchi S, Tanaka R. Evaluation of the stability of aneurysms after embolization using detachable coils: correlation between stability of aneurysms and embolized volume of aneurysms. AJNR Am J Neuroradiol. 2002; 23: 762–767.
16. Moret J, Ross IB, Weill A, Piotin M. The retrograde approach: a consideration for the endovascular treatment of aneurysms. AJNR Am J Neuroradiol. 2000; 21: 262–268.
17. Raymond J, Guilbert F, Roy D. Neck-bridge device for endovascular treatment of wide-neck bifurcation aneurysms: initial experience. Radiology. 2001; 221: 318–326.
18. Raymond J, Roy D, Bojanowski M, Moumdjian R, L’Esperance G. Endovascular treatment of acutely ruptured and unruptured aneurysms of the basilar bifurcation. J Neurosurg. 1997; 86: 211–219.[Medline] [Order article via Infotrieve]
19. Roy D, Raymond J, Bouthillier A, Bojanowski MW, Moumdjian R, L’Esperance G. Endovascular treatment of ophthalmic segment aneurysms with Guglielmi detachable coils. AJNR Am J Neuroradiol. 1997; 18: 1207–1215.[Abstract]
20. Lin T, Fox AJ, Drake CG. Regrowth of aneurysm sacs from residual neck following aneurysm clipping. J Neurosurg. 1989; 70: 556–560.[Medline] [Order article via Infotrieve]
21. Mawad ME, Cekirge S, Ciceri E, Saatci I. Endovascular treatment of giant and large intracranial aneurysms by using a combination of stent placement and liquid polymer injection. J Neurosurg. 2002; 96: 474–482.[Medline] [Order article via Infotrieve]
22. Raymond J, Leblanc P, Desfaits AC, Salazkin I, Morel F, Janicki C, Roorda S. In situ beta radiation to prevent recanalization after coil embolization of cerebral aneurysms. Stroke. 2002; 33: 421–427.
23. Dion JE, Gates PC, Fox AJ, Barnett HJ, Blom RJ. Clinical events following neuroangiography: a prospective study. Stroke. 1987; 18: 997–1004.
24. Cloft HJ, Joseph GJ, Dion JE. Risk of cerebral angiography in patients with subarachnoid hemorrhage, cerebral aneurysm, and arteriovenous malformation: a meta-analysis. Stroke. 1999; 30: 317–320.
25. Civit T, Auque J, Marchal JC, Bracard S, Picard L, Hepner H. Aneurysm clipping after endovascular treatment with coils: a report of eight patients. Neurosurgery. 1996; 38: 955–960;discussion 960–961.
26. The International Study of Unruptured Intracranial Aneurysms Investigators (Wiebers DO). Unruptured intracranial aneurysms: risk of rupture and risks of surgical intervention: International Study of Unruptured Intracranial Aneurysms Investigators. N Engl J Med. 1998; 339: 1725–1733.
This article has been cited by other articles:
 |
|
 |
|
  M.-H. Li, Y.-D. Li, H.-Q. Tan, Q.-Y. Luo, and Y.-S. Cheng Treatment of Distal Internal Carotid Artery Aneurysm with the Willis Covered Stent: A Prospective Pilot Study Radiology, November 1, 2009; 253(2): 470 - 477. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D A Lott, M Siegel, H R Chaudhry, and C J Prestigiacomo Computational fluid dynamic simulation to assess flow characteristics of an in vitro aneurysm model JNIS, October 30, 2009; (2009) jnis.2009.000463v1. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D Fiorella and H H Woo Balloon assisted treatment of intracranial aneurysms: the conglomerate coil mass technique JNIS, October 30, 2009; (2009) jnis.2009.000547v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W.J. van Rooij and M. Sluzewski Opinion: Imaging Follow-Up after Coiling of Intracranial Aneurysms AJNR Am. J. Neuroradiol., October 1, 2009; 30(9): 1646 - 1648. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Raymond Counterpoint: Has the Last Word Been Said? AJNR Am. J. Neuroradiol., October 1, 2009; 30(9): 1649 - 1652. [Full Text] [PDF]
|
|
|
|
|
|
M.E.S. Sprengers, J.D. Schaafsma, W.J. van Rooij, R. van den Berg, G.J.E. Rinkel, E.M. Akkerman, S.P. Ferns, and C.B.L.M. Majoie Evaluation of the Occlusion Status of Coiled Intracranial Aneurysms with MR Angiography at 3T: Is Contrast Enhancement Necessary? AJNR Am. J. Neuroradiol., October 1, 2009; 30(9): 1665 - 1671. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Gunnarsson, F.C. Tong, P. Klurfan, C.M. Cawley, and J.E. Dion Angiographic and Clinical Outcomes in 200 Consecutive Patients with Cerebral Aneurysm Treated with Hydrogel-Coated Coils AJNR Am. J. Neuroradiol., October 1, 2009; 30(9): 1657 - 1664. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.-F. Vendrell, N. Menjot, V. Costalat, D. Hoa, J. Moritz, H. Brunel, and A. Bonafe Endovascular Treatment of 174 Middle Cerebral Artery Aneurysms: Clinical Outcome and Radiologic Results at Long-term Follow-up Radiology, October 1, 2009; 253(1): 191 - 198. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D Fiorella, F C Albuquerque, H Woo, P A Rasmussen, T J Masaryk, and C G McDougall Neuroform stent assisted aneurysm treatment: evolving treatment strategies, complications and results of long term follow-up JNIS, September 15, 2009; (2009) jnis.2009.000521v1. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Kau, J. Gasser, S. Celedin, E. Rabitsch, W. Eicher, E. Uhl, and K.A. Hausegger MR Angiographic Follow-Up of Intracranial Aneurysms Treated with Detachable Coils: Evaluation of a Blood-Pool Contrast Medium AJNR Am. J. Neuroradiol., September 1, 2009; 30(8): 1524 - 1530. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. Linfante, M.J. DeLeo III, M.J. Gounis, C.S. Brooks, and A.K. Wakhloo Cerecyte versus Platinum Coils in the Treatment of Intracranial Aneurysms: Packing Attenuation and Clinical and Angiographic Midterm Results AJNR Am. J. Neuroradiol., September 1, 2009; 30(8): 1496 - 1501. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. P. Ferns, M. E.S. Sprengers, W. J. van Rooij, G. J.E. Rinkel, J. C. van Rijn, S. Bipat, M. Sluzewski, and C. B.L.M. Majoie Coiling of Intracranial Aneurysms: A Systematic Review on Initial Occlusion and Reopening and Retreatment Rates Stroke, August 1, 2009; 40(8): e523 - e529. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. P. Greving, G. J.E. Rinkel, E. Buskens, and A. Algra Cost-effectiveness of preventive treatment of intracranial aneurysms: New data and uncertainties Neurology, July 28, 2009; 73(4): 258 - 265. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D Fiorella, P Lylyk, I Szikora, M E Kelly, F C Albuquerque, C G McDougall, and P K Nelson Curative cerebrovascular reconstruction with the Pipeline embolization device: the emergence of definitive endovascular therapy for intracranial aneurysms JNIS, July 1, 2009; 1(1): 56 - 65. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Pierot, L. Spelle, X. Leclerc, C. Cognard, A. Bonafe, and J. Moret Endovascular Treatment of Unruptured Intracranial Aneurysms: Comparison of Safety of Remodeling Technique and Standard Treatment with Coils Radiology, June 1, 2009; 251(3): 846 - 855. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R.A. Willinsky, J. Peltz, L. da Costa, R. Agid, R.I. Farb, and K.G. terBrugge Clinical and Angiographic Follow-up of Ruptured Intracranial Aneurysms Treated with Endovascular Embolization AJNR Am. J. Neuroradiol., May 1, 2009; 30(5): 1035 - 1040. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. D. Schaafsma, M. E. Sprengers, W. J. van Rooij, M. Sluzewski, C. B.L.M. Majoie, M. J.H. Wermer, and G. J.E. Rinkel Long-Term Recurrent Subarachnoid Hemorrhage After Adequate Coiling Versus Clipping of Ruptured Intracranial Aneurysms Stroke, May 1, 2009; 40(5): 1758 - 1763. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. B. Bederson, E. S. Connolly Jr, H. H. Batjer, R. G. Dacey, J. E. Dion, M. N. Diringer, J. E. Duldner Jr, R. E. Harbaugh, A. B. Patel, and R. H. Rosenwasser Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage: A Statement for Healthcare Professionals From a Special Writing Group of the Stroke Council, American Heart Association Stroke, March 1, 2009; 40(3): 994 - 1025. [Full Text] [PDF]
|
|
|
|
|
|
P.M. White and J. Raymond Endovascular Coiling of Cerebral Aneurysms Using "Bioactive" or Coated-Coil Technologies: A Systematic Review of the Literature AJNR Am. J. Neuroradiol., February 1, 2009; 30(2): 219 - 226. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Piotin, L. Spelle, C. Mounayer, C. Loureiros, A. Ghorbani, and J. Moret Intracranial Aneurysms Coiling With Matrix: Immediate Results in 152 Patients and Midterm Anatomic Follow-Up From 115 Patients Stroke, January 1, 2009; 40(1): 321 - 323. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. K. Wakhloo, J. Mandell, M. J. Gounis, C. Brooks, I. Linfante, J. Winer, and J. P. Weaver Stent-Assisted Reconstructive Endovascular Repair of Cranial Fusiform Atherosclerotic and Dissecting Aneurysms: Long-Term Clinical and Angiographic Follow-Up Stroke, December 1, 2008; 39(12): 3288 - 3296. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M.E. Sprengers, J. Schaafsma, W.J. van Rooij, M. Sluzewski, G.J.E. Rinkel, B.K. Velthuis, J.C. van Rijn, and C.B. Majoie Stability of Intracranial Aneurysms Adequately Occluded 6 Months after Coiling: A 3T MR Angiography Multicenter Long-Term Follow-Up Study AJNR Am. J. Neuroradiol., October 1, 2008; 29(9): 1768 - 1774. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.-M. Isokangas, T. Siniluoto, T. Tikkakoski, and T. Kumpulainen Endovascular Treatment of Peripheral Aneurysms of the Posterior Inferior Cerebellar Artery AJNR Am. J. Neuroradiol., October 1, 2008; 29(9): 1783 - 1788. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Anzalone, F. Scomazzoni, M. Cirillo, C. Righi, F. Simionato, M. Cadioli, A. Iadanza, M.A. Kirchin, and G. Scotti Follow-Up of Coiled Cerebral Aneurysms at 3T: Comparison of 3D Time-of-Flight MR Angiography and Contrast-Enhanced MR Angiography AJNR Am. J. Neuroradiol., September 1, 2008; 29(8): 1530 - 1536. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Pierot, L. Spelle, F. Vitry, and for the ATENA Investigators Immediate Clinical Outcome of Patients Harboring Unruptured Intracranial Aneurysms Treated by Endovascular Approach: Results of the ATENA Study Stroke, September 1, 2008; 39(9): 2497 - 2504. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S.A. Renowden, P. Koumellis, V. Benes, W. Mukonoweshuro, A.J. Molyneux, and N.S. McConachie Retreatment of Previously Embolized Cerebral Aneurysms: The Risk of Further Coil Embolization Does Not Negate the Advantage of the Initial Embolization AJNR Am. J. Neuroradiol., August 1, 2008; 29(7): 1401 - 1404. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Holmin, T. Krings, A. Ozanne, J.-P. Alt, A. Claes, W. Zhao, H. Alvarez, G. Rodesch, and P. Lasjaunias Intradural Saccular Aneurysms Treated by Guglielmi Detachable Bare Coils at a Single Institution Between 1993 and 2005: Clinical Long-Term Follow-Up for a Total of 1810 Patient-Years in Relation to Morphological Treatment Results Stroke, August 1, 2008; 39(8): 2288 - 2297. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. R. SCHONFELD and M. A McMULLEN Treatment of Brain Aneurysms Radiol. Technol., July 1, 2008; 79(6): 515 - 531. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y.-S. Guan and M.-Q. Wang Endovascular Embolization of Intracranial Aneurysms Angiology, July 1, 2008; 59(3): 342 - 351. [Abstract] [PDF]
|
|
|
|
|
|
J. Raymond, T. Darsaut, I. Salazkin, G. Gevry, and F. Bouzeghrane Mechanisms of Occlusion and Recanalization in Canine Carotid Bifurcation Aneurysms Embolized with Platinum Coils: An Alternative Concept AJNR Am. J. Neuroradiol., April 1, 2008; 29(4): 745 - 752. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Standhardt, H. Boecher-Schwarz, A. Gruber, T. Benesch, E. Knosp, and G. Bavinzski Endovascular Treatment of Unruptured Intracranial Aneurysms With Guglielmi Detachable Coils: Short- and Long-Term Results of a Single-Centre Series Stroke, March 1, 2008; 39(3): 899 - 904. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P.M. White, S.C. Lewis, H. Nahser, R.J. Sellar, T. Goddard, A. Gholkar, and on behalf of the HELPS Trial Collaboration HydroCoil Endovascular Aneurysm Occlusion and Packing Study (HELPS Trial): Procedural Safety and Operator-Assessed Efficacy Results AJNR Am. J. Neuroradiol., February 1, 2008; 29(2): 217 - 223. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Butteriss, A. Gholkar, D. Mitra, D. Birchall, and V. Jayakrishnan Single-Center Experience of Cerecyte Coils in the Treatment of Intracranial Aneurysms: Initial Experience and Early Follow-Up Results AJNR Am. J. Neuroradiol., January 1, 2008; 29(1): 53 - 56. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Pierot, X. Leclerc, A. Bonafe, S. Bracard, and for the French Matrix Registry Investigators Endovascular Treatment of Intracranial Aneurysms with Matrix Detachable Coils: Midterm Anatomic Follow-Up from a Prospective Multicenter Registry AJNR Am. J. Neuroradiol., January 1, 2008; 29(1): 57 - 61. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Gallas, J. Drouineau, J. Gabrillargues, A. Pasco, C. Cognard, L. Pierot, and D. Herbreteau Feasibility, Procedural Morbidity and Mortality, and Long-Term Follow-Up of Endovascular Treatment of 321 Unruptured Aneurysms AJNR Am. J. Neuroradiol., January 1, 2008; 29(1): 63 - 68. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D.J. Rivet, C.J. Moran, A. Mazumdar, T.K. Pilgram, C.P. Derdeyn, and D.T. Cross Single-Institution Experience with Matrix Coils in the Treatment of Intracranial Aneurysms: Comparison with Same-Center Outcomes with the Use of Platinum Coils AJNR Am. J. Neuroradiol., October 1, 2007; 28(9): 1736 - 1742. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Ries, S. Siemonsen, G. Thomalla, U. Grzyska, H. Zeumer, and J. Fiehler Long-Term Follow-Up of Cerebral Aneurysms after Endovascular Therapy Prediction and Outcome of Retreatment AJNR Am. J. Neuroradiol., October 1, 2007; 28(9): 1755 - 1761. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Kadirvel, Y.-H. Ding, D. Dai, D. A. Lewis, H. J. Cloft, and D. F. Kallmes Molecular Indices of Apoptosis Activation in Elastase-Induced Aneurysms After Embolization With Platinum Coils Stroke, October 1, 2007; 38(10): 2787 - 2794. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Bendszus, A. J. Bartsch, and L. Solymosi Endovascular Occlusion of Aneurysms Using a New Bioactive Coil: A Matched Pair Analysis With Bare Platinum Coils Stroke, October 1, 2007; 38(10): 2855 - 2857. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Abruzzo, T. Tun, and A. Sambanis Efficient Transmicrocatheter Delivery of Functional Fibroblasts with a Bioengineered Collagen Gel-Platinum Microcoil Complex: Toward the Development of Endovascular Cell Therapy for Cerebral Aneurysms AJNR Am. J. Neuroradiol., September 1, 2007; 28(8): 1586 - 1593. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Sluzewski and W.J. van Rooij Packing Performance of Helical Guglielmi Detachable Coil (GDC) 18 in Intracranial Aneurysms: A Comparison with Helical GDC 10 Coils and Complex Trufill/Orbit Coils AJNR Am. J. Neuroradiol., August 1, 2007; 28(7): 1384 - 1387. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A.K. Wakhloo, M.J. Gounis, J.S. Sandhu, N. Akkawi, A.E. Schenck, and I. Linfante Complex-Shaped Platinum Coils for Brain Aneurysms: Higher Packing Density, Improved Biomechanical Stability, and Midterm Angiographic Outcome AJNR Am. J. Neuroradiol., August 1, 2007; 28(7): 1395 - 1400. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D.F. Kallmes and H.J. Cloft Ready or Not, Here They Come: Randomized Trials Evaluating New Endovascular Aneurysm Therapies AJNR Am. J. Neuroradiol., May 1, 2007; 28(5): 799 - 803. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Kadirvel, D. Dai, Y.H. Ding, M.A. Danielson, D.A. Lewis, H.J. Cloft, and D.F. Kallmes Endovascular Treatment of Aneurysms: Healing Mechanisms in a Swine Model Are Associated with Increased Expression of Matrix Metalloproteinases, Vascular Cell Adhesion Molecule-1, and Vascular Endothelial Growth Factor, and Decreased Expression of Tissue Inhibitors of Matrix Metalloproteinases AJNR Am. J. Neuroradiol., May 1, 2007; 28(5): 849 - 856. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Piotin, L. Spelle, C. Mounayer, M. T. Salles-Rezende, D. Giansante-Abud, R. Vanzin-Santos, and J. Moret Intracranial Aneurysms: Treatment with Bare Platinum Coils--Aneurysm Packing, Complex Coils, and Angiographic Recurrence Radiology, May 1, 2007; 243(2): 500 - 508. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Campi, N. Ramzi, A. J. Molyneux, P. E. Summers, R. S.C. Kerr, M. Sneade, J. A. Yarnold, J. Rischmiller, and J. V. Byrne Retreatment of Ruptured Cerebral Aneurysms in Patients Randomized by Coiling or Clipping in the International Subarachnoid Aneurysm Trial (ISAT) Stroke, May 1, 2007; 38(5): 1538 - 1544. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. Linfante and A. K. Wakhloo Brain Aneurysms and Arteriovenous Malformations: Advancements and Emerging Treatments in Endovascular Embolization Stroke, April 1, 2007; 38(4): 1411 - 1417. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H.J. Cloft, T. Kaufmann, and D.F. Kallmes Observer Agreement in the Assessment of Endovascular Aneurysm Therapy and Aneurysm Recurrence AJNR Am. J. Neuroradiol., March 1, 2007; 28(3): 497 - 500. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Mitra, A. Herwadkar, C. Soh, and A. Gholkar Follow-Up of Intracranial Aneurysms Treated with Matrix Detachable Coils: A Single-Center Experience AJNR Am. J. Neuroradiol., February 1, 2007; 28(2): 362 - 367. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W.J. van Rooij and M. Sluzewski Packing Performance of GDC 360{degrees} Coils in Intracranial Aneurysms: A Comparison with Complex Orbit Coils and Helical GDC 10 Coils AJNR Am. J. Neuroradiol., February 1, 2007; 28(2): 368 - 370. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H.J. Cloft and for the HEAL Investigators HydroCoil for Endovascular Aneurysm Occlusion (HEAL) Study: 3-6 Month Angiographic Follow-Up Results AJNR Am. J. Neuroradiol., January 1, 2007; 28(1): 152 - 154. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Bendszus and L. Solymosi Cerecyte Coils in the Treatment of Intracranial Aneurysms: A Preliminary Clinical Study AJNR Am. J. Neuroradiol., November 1, 2006; 27(10): 2053 - 2057. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Berenstein, J.K. Song, Y. Niimi, K. Namba, N.S. Heran, J.L. Brisman, M.C. Nahoum, M. Madrid, D.J. Langer, and M.J. Kupersmith Treatment of Cerebral Aneurysms with Hydrogel-Coated Platinum Coils (HydroCoil): Early Single-Center Experience. AJNR Am. J. Neuroradiol., October 1, 2006; 27(9): 1834 - 1840. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Pierot, A. Bonafe, S. Bracard, X. Leclerc, and for the French Matrix Registry Investigators Endovascular treatment of intracranial aneurysms with matrix detachable coils: immediate posttreatment results from a prospective multicenter registry. AJNR Am. J. Neuroradiol., September 1, 2006; 27(8): 1693 - 1699. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. L. Brisman, J. K. Song, and D. W. Newell Cerebral aneurysms. N. Engl. J. Med., August 31, 2006; 355(9): 928 - 939. [Full Text] [PDF]
|
|
|
|
|
|
R. C. Gaba, S. A. Ansari, S. S. Roy, F. A. Marden, M. A.G. Viana, and T. W. Malisch Embolization of Intracranial Aneurysms With Hydrogel-Coated Coils Versus Inert Platinum Coils: Effects on Packing Density, Coil Length and Quantity, Procedure Performance, Cost, Length of Hospital Stay, and Durability of Therapy Stroke, June 1, 2006; 37(6): 1443 - 1450. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M.-H. Li, B.-L. Gao, C. Fang, B.-X. Gu, Y.-S. Cheng, W. Wang, and G. Scotti Angiographic Follow-Up of Cerebral Aneurysms Treated with Guglielmi Detachable Coils: An Analysis of 162 Cases with 173 Aneurysms. AJNR Am. J. Neuroradiol., May 1, 2006; 27(5): 1107 - 1112. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Niimi, J. Song, M. Madrid, and A. Berenstein Endosaccular Treatment of Intracranial Aneurysms Using Matrix Coils: Early Experience and Midterm Follow-Up Stroke, April 1, 2006; 37(4): 1028 - 1032. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.-Y. Gauvrit, X. Leclerc, S. Caron, C. A. Taschner, J.-P. Lejeune, and J.-P. Pruvo Intracranial Aneurysms Treated With Guglielmi Detachable Coils: Imaging Follow-Up With Contrast-Enhanced MR Angiography Stroke, April 1, 2006; 37(4): 1033 - 1037. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. K. Wakhloo, B. B. Lieber, G. Canton, D. I. Levy, J. C. Lasheras, and C. Geindreau Changes of Intra-Aneurysmal Pressure during Coiling AJNR Am. J. Neuroradiol., March 1, 2006; 27(3): 471 - 474. [Full Text] [PDF]
|
|
|
|
|
|
H. J. Cloft Have you been smoking something that is biologically active? AJNR Am. J. Neuroradiol., February 1, 2006; 27(2): 240 - 242. [Full Text] [PDF]
|
|
|
|
|
|
H.J. Cloft and for the HEAL Investigators HydroCoil for Endovascular Aneurysm Occlusion (HEAL) Study: Periprocedural Results. AJNR Am. J. Neuroradiol., February 1, 2006; 27(2): 289 - 292. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. L. Feigin and M. Findlay Advances in Subarachnoid Hemorrhage Stroke, February 1, 2006; 37(2): 305 - 308. [Full Text] [PDF]
|
|
|
|
|
|
V. Costalat, E. Lebars, L. Sarry, A. Defasque, E. Barbotte, H. Brunel, G. Bourbotte, and A. Bonafe In Vitro Evaluation of 2D-Digital Subtraction Angiography versus 3D-Time-of-Flight in Assessment of Intracranial Cerebral Aneurysm Filling after Endovascular Therapy AJNR Am. J. Neuroradiol., January 1, 2006; 27(1): 177 - 184. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. L. Turner, J. N. P. Higgins, A. Gholkar, A. D. Mendelow, A. J. Molyneux, R. S.C. Kerr, S. Chawda, and P. J. Kirkpatrick Intracranial Aneurysms Treated With Endovascular Coils: Detection of Recurrences Using Unenhanced and Contrast-Enhanced Transcranial Color-Coded Duplex Sonography Stroke, December 1, 2005; 36(12): 2654 - 2659. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Sluzewski, W. J. van Rooij, G. N. Beute, and P. C. Nijssen Late Rebleeding of Ruptured Intracranial Aneurysms Treated with Detachable Coils AJNR Am. J. Neuroradiol., November 1, 2005; 26(10): 2542 - 2549. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Iijima, M. Piotin, C. Mounayer, L. Spelle, A. Weill, and J. Moret Endovascular Treatment with Coils of 149 Middle Cerebral Artery Berry Aneurysms Radiology, November 1, 2005; 237(2): 611 - 619. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. A. Taschner, X. Leclerc, H. Rachdi, A. M. Barros, and J.-P. Pruvo Matrix Detachable Coils for the Endovascular Treatment of Intracranial Aneurysms: Analysis of Early Angiographic and Clinical Outcomes Stroke, October 1, 2005; 36(10): 2176 - 2180. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. K. Goddard, C. J. Moran, D. T. Cross III, and C. P. Derdeyn Absent Relationship between the Coil-Embolization Ratio in Small Aneurysms Treated with a Single Detachable Coil and Outcomes AJNR Am. J. Neuroradiol., September 1, 2005; 26(8): 1916 - 1920. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H.-S. Kang, M. H. Han, B. J. Kwon, O-K. Kwon, S. H. Kim, S. H. Choi, and K.-H. Chang Short-Term Outcome of Intracranial Aneurysms Treated with Polyglycolic Acid/Lactide Copolymer-Coated Coils Compared to Historical Controls Treated with Bare Platinum Coils: A Single-Center Experience AJNR Am. J. Neuroradiol., September 1, 2005; 26(8): 1921 - 1928. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. Linfante, N. M. Akkawi, A. Perlow, V. Andreone, and A. K. Wakhloo Polyglycolide/Polylactide-Coated Platinum Coils for Patients With Ruptured and Unruptured Cerebral Aneurysms: A Single-Center Experience Stroke, September 1, 2005; 36(9): 1948 - 1953. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Gallas, A. Pasco, J.-P. Cottier, J. Gabrillargues, J. Drouineau, C. Cognard, and D. Herbreteau A Multicenter Study of 705 Ruptured Intracranial Aneurysms Treated with Guglielmi Detachable Coils AJNR Am. J. Neuroradiol., August 1, 2005; 26(7): 1723 - 1731. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Lubicz, X. Leclerc, J.-Y. Gauvrit, J.-P. Lejeune, and J.-P. Pruvo Three-Dimensional Packing with Complex Orbit Coils for the Endovascular Treatment of Intracranial Aneurysms AJNR Am. J. Neuroradiol., June 1, 2005; 26(6): 1342 - 1348. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. B. L. M. Majoie, M. E. Sprengers, W. J. J. van Rooij, C. Lavini, M. Sluzewski, J. C. van Rijn, and G. J. den Heeten MR Angiography at 3T versus Digital Subtraction Angiography in the Follow-up of Intracranial Aneurysms Treated with Detachable Coils AJNR Am. J. Neuroradiol., June 1, 2005; 26(6): 1349 - 1356. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Lubicz, M. Piotin, C. Mounayer, L. Spelle, and J. Moret Selective Endovascular Treatment of Intracranial Aneurysms with a Liquid Embolic: A Single-Center Experience in 39 Patients with 41 Aneurysms AJNR Am. J. Neuroradiol., April 1, 2005; 26(4): 885 - 893. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. J. Slob, W. J. van Rooij, and M. Sluzewski Coil Thickness and Packing of Cerebral Aneurysms: A Comparative Study of Two Types of Coils AJNR Am. J. Neuroradiol., April 1, 2005; 26(4): 901 - 903. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. F. M. Wijdicks, D. F. Kallmes, E. M. Manno, J. R. Fulgham, and D. G. Piepgras Subarachnoid Hemorrhage: Neurointensive Care and Aneurysm Repair Mayo Clin. Proc., April 1, 2005; 80(4): 550 - 559. [Abstract] [PDF]
|
|
|
|
|
|
B. Lubicz, X. Leclerc, J.-Y. Gauvrit, J.-P. Lejeune, and J.-P. Pruvo Endovascular Treatment of Intracranial Aneurysms with Matrix Coils: A Preliminary Study of Immediate Post-treatment Results AJNR Am. J. Neuroradiol., February 1, 2005; 26(2): 373 - 375. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Raymond, I. Salazkin, A. Metcalfe, O. Robledo, G. Gevry, D. Roy, A. Weill, and F. Guilbert Lingual Artery Bifurcation Aneurysms for Training and Evaluation of Neurovascular Devices AJNR Am. J. Neuroradiol., September 1, 2004; 25(8): 1387 - 1390. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Pelz, P. Lylyk, and M. Negoro Interventional Neuroradiology Stroke, February 1, 2004; 35(2): 381 - 382. [Full Text] [PDF]
|
|
|
|
|
|
J. Raymond, D. Roy, P. Leblanc, S. Roorda, C. Janicki, L. Normandeau, F. Morel, G. Gevry, J.-P. Bahary, M. Chagnon, et al. Endovascular Treatment of Intracranial Aneurysms With Radioactive Coils: Initial Clinical Experience Stroke, December 1, 2003; 34(12): 2801 - 2806. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. S. Ogilvy Neurosurgical Clipping Versus Endovascular Coiling of Patients With Ruptured Intracranial Aneurysms Stroke, October 1, 2003; 34(10): 2540 - 2542. [Full Text] [PDF]
|
|
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||