MR-DWI-Positive Lesions and Symptomatic Ischemic Complications After Coiling of Unruptured Intracranial Aneurysms

作者：Kang Dong Hun; Kim Byung Moon^*; Kim Dong Joon; Suh Sang Hyun; Kim Dong Ik; Kim Yong Sun; Huh Seung Kon; Park Jaechan; Lee Jae Whan; Kim Yong Bae

来源：Stroke, 2013, 44(3): 789-791.

DOI：10.1161/STROKEAHA.112.669853

• coils
• intracranial aneurysm
• outcomes

Background and Purpose-The aims of this study are to evaluate the risk factors for symptomatic ischemic complication (symptomatic ischemic complication [SIC], transient ischemic attack, or stroke) and microembolisms detected as MR diffusion-weighted imaging (MR-DWI)-positive (DWI(+)) lesions, and the relationship between DWI(+) and SIC after coiling of unruptured intracranial aneurysm.
Methods-Between March 2009 and November 2011, 382 unruptured intracranial aneurysms in 343 patients underwent both coiling and posttreatment MR-DWI. The incidence of and risk factors for SIC and DWI(+), and the relationship between DWI(+) and SIC were retrospectively analyzed.
Results-The incidence of SIC was 4.1%. The incidence of DWI(+) was 54.5%. The number of DWI(+) lesions was significantly larger in the SIC group, than in the asymptomatic one (12.1 +/- 10.4 versus 5.0 +/- 8.7, P<0.00). The cutoff value of DWI(+) for predicting SIC was >= 6 (sensitivity 85.7%, specificity 70.7%). The patients with DWI(+) >= 6 was 28.6%. Of the patients with SIC, the patients with DWI(+) >= 6 was 78.6%. Patients aged >= 65 years had a trend for SIC, and it was the only independent risk factor for DWI(+) >= cutoff (n=6; 95% CI, 1.167-3.083).
Conclusions-The number of DWI(+) lesions was significantly larger in the SIC group than in the asymptomatic one after coiling of unruptured intracranial aneurysm. Patients aged >= 65 had a trend for SIC, and it was the only independent risk factor for the number of DWI(+) >= cutoff value (n=6) for predicting SIC. (Stroke. 2013;44:789-791.)

• 出版日期2013-3