Long-term Outcomes of Coil Packing for Visceral Aneurysms: Correlation between Packing Density and Incidence of Coil Compaction or Recanalization

• Published in: Journal of vascular and interventional radiology Vol. 24; no. 12; pp. 1798 - 1807
• Main Authors: Yasumoto, Taku, MD, PhD, Osuga, Keigo, MD, PhD, Yamamoto, Hiroshi, MD, Ono, Yusuke, MD, Masada, Maki, MD, Mikami, Koji, MD, Kanamori, Daigo, MD, Nakamura, Masahisa, MD, Tanaka, Kaisyu, MD, Nakazawa, Tetsuro, MD, PhD, Higashihara, Hiroki, MD, PhD, Maeda, Noboru, MD, PhD, Tomiyama, Noriyuki, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2013
• Subjects: Adult; Aged; Aged, 80 and over; Aneurysm - diagnosis; Aneurysm - therapy; Embolization, Therapeutic - adverse effects; Embolization, Therapeutic - instrumentation; Embolization, Therapeutic - methods; Female; Humans; Male; Middle Aged; Multidetector Computed Tomography; Radiology; Recurrence; Retrospective Studies; Time Factors; Treatment Outcome; Viscera - blood supply; 3D; three-dimensional; visceral artery aneurysm; VAA
• ISSN: 1051-0443; 1535-7732
• DOI: 10.1016/j.jvir.2013.04.030

Abstract Purpose To evaluate the correlation between packing density and the incidence of coil compaction or recanalization of visceral artery aneurysms (VAAs) after coil packing. Materials and Methods Between July 2004 and April 2012, coil packing was performed for 46 true visceral aneurysms (16 splenic, 11 pancreaticoduodenal, eight renal, six hepatic, three superior mesenteric, one right gastric, and one gastroepiploic) in 42 patients. The size and volume of the aneurysm, packing density, and the incidences of compaction and recanalization were evaluated retrospectively. Results The mean follow-up period was 37 months ± 8 (range, 11–80 mo). The mean packing density was 19% ± 8 (range, 5%–42%), mean aneurysm size was 19 mm ± 8 (range, 5–40 mm), and mean volume was 4,108 mm3 ± 5,435 (range, 72–26,235 mm3 ). Compaction and recanalization occurred in two (4%) and 12 aneurysms (26%), respectively. The mean packing density was significantly lower in aneurysms with compaction or recanalization than in unaffected aneurysms (12% vs 22%; P = .00014). There was a significant difference in mean packing density between small (< 20 mm; 22%) and large (≥ 20 mm) aneurysms (15%; P = .0045). The mean size and volume were significantly larger for coil-compacted or recanalized aneurysms than for unaffected aneurysms ( P < .05). In aneurysms with a packing density of at least 24%, no compaction or recanalization occurred. Conclusions Coil compaction or recanalization after coil packing for VAAs more often occurs after insufficient embolization with low packing density and in patients with large aneurysms.