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Large postoperative inflow area predictive of recurrence for paraclinoid aneurysms treated by simple coiling

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OBJECTIVES This study aims to investigate recurrence risk factors of simply coiled unruptured paraclinoid aneurysms based on a porous medium model (POM). METHODS Twenty unruptured coiled paraclinoid aneurysms with digital… Click to show full abstract

OBJECTIVES This study aims to investigate recurrence risk factors of simply coiled unruptured paraclinoid aneurysms based on a porous medium model (POM). METHODS Twenty unruptured coiled paraclinoid aneurysms with digital subtract angiography (DSA) follow-up were enrolled to analyze morphological and hemodynamic variables to predict recurrence. RESULTS Recurrent aneurysms have larger neck areas than stable aneurysms (34.43 ± 21.46 mm2 vs. 16.12 ± 7.10 mm2; p = 0.048). For hemodynamic variables, recurrent aneurysms had larger preoperative (16.40 ± 11.38 mm2 vs. 7.87 ± 3.75 mm2; p = 0.048) and postoperative inflow areas (14.07 ± 6.80 mm2 versus 6.73 ± 4.20 mm2; p = 0.021) than the stable group. Only the postoperative inflow area (p = 0.031, OR = 1.289; 95% CI 1.024-1.624) was an independent predictor of recurrence after multivariate regression analysis. The receiver operating characteristic (ROC) curve analysis efficiently predicted recurrence (AUC = 0.833, p = 0.021) with an inflow area cutoff value (9.15 mm2; sensitivity, 0.833; specificity, 0.857). CONCLUSIONS Neck area along with pre- and postoperative inflow areas were associated with aneurysm recurrence. These findings suggest that a large postoperative inflow area independently predicts the recurrence of coiled paraclinoid aneurysms.

Keywords: recurrence; inflow area; paraclinoid aneurysms; postoperative inflow

Journal Title: Journal of Clinical Neuroscience
Year Published: 2022

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