Thromboembolic Event Detected by Diffusion Weighted Magnetic Resonance Imaging After Coil Embolization of Cerebral Aneurysms

초록

Objective : The purpose of this study was to evaluate the occurrencerate of diffusion positive lesions (DPLs), and to assess the peri-proceduralrisk factors for the occurrence of DPLs in patients who underwent coilembolization of cerebral aneurysms. Materials and Methods : A total of 304 saccular aneurysms were embolizedduring a seven-year period from Jan 2007 to Dec 2013. Of these,postoperative diffusion-weighted images were obtained in 186 procedures. There were 100 ruptured aneurysm and 86 unruptured aneurysms. Thecoiling procedures were as follows: simple coiling in 96, balloon assistedcoiling (BAC) in 39, and stent assisted coiling (SAC) in 51 aneurysms. Clinical, angiographic and procedural factors were analyzed in relation tothe occurrence of DPLs. Results : Overall, DPLs were observed in 50.5%. In unruptured aneurysms,DPLs occurred in 23.5% of BAC, 41.9% of SAC and 57.7% of simple coiling(p = 0.08). Among ruptured aneurysms, DPLs occurred in 63.6% of BAC,62.5% of SAC and 54.3% of simple coiling (p = 0.71). DPLs had a tendencyto increase in ruptured aneurysms compared with unruptured aneurysms(57% vs. 43%, p = 0.077). Logistic regression analysis revealed that age > 55years was the only independent risk factor for the occurrence of DPLs. Conclusion : DPLs occured more frequently in ruptured aneurysm and atan older age. Although most DPLs are asymptomatic, careful manipulationof cerebral or extracerebral arteries using various endovascular devices isimportant to reducing the occurrence of DPLs. BAC appeared to reduceoccurrence of TE events in patient with unruptured aneurysm.

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