ANALYSIS OF RISK FACTORS FOR PERIFOCAL EDEMA AFTER ENDOVASCULAR EMBOLIZATION OF UNRUPTURED INTRACRANIAL ARTERIAL ANEURYSMS

Abstract

Background. Endovascular embolization is a treatment of choice for the management of unruptured intracranial aneurysms, but sometimes is complicated with perianeurysmal edema.

Objective. The aim of our study was to establish incidence and outcomes of perianeurysmal edema after endovascular coiling of unruptured intracranial aneurysms, and to reveal possible risk factors for development of this potentially serious complication.

Methods. In total 119 adult patients with endovascular embolization of unruptured intracranial aneurysm (performed at Department for Interventional Neuroradiology, Clinical Center, Kragujevac, Serbia) were included in our study. The embolizations were made by electrolite-detachable platinum coils: pure platinum, hydrophilic and combination of platinum and hydrophilic coils. Primary outcome variable was perianeurysmal edema visualized by Nuclear Magnetic Resonance (NMR) imaging 7, 30 and 90 days after the embolization.

Results. The perianurysmal edema appeared in 47.6% of patients treated with hydrophilic coils, in 21.6% of patients treated with platinum coils, and in 53.8% of those treated with mixed type of the coils. The multivariate logistic regression showed that varibles associated with occurence of perianeurysmal edema are volume of the aneurysm, hypertension, diabetes and smoking habit. Hypertension is the most important independent predictor of the perianeurysmal edema, followed by smoking and diabetes.

Conclusions. The results of our study suggest that older patients with larger unruptured intracranial aneurysms, who suffer from diabetes mellitus and hypertension, and have the smoking habit, are under much higher risk of having perianeurysmal edema after endovascular coiling