Presence of small and large branch vessels from intracranial aneurysms increases the risk of post-treatment recurrence and retreatment following endovascular coiling: insights from a propensity score-matched cohort
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By
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March 25, 2026
Objective:
To determine the impact of branch vessel involvement on angiographic occlusion, clinical outcomes, recurrence, and retreatment after endovascular coiling, specifically focusing on the challenges posed by this morphological feature.
Key Findings:
- 11.8% of aneurysms had branch vessel involvement.
- BVAs had worse final Raymond-Roy grade (OR: 6.33, 95% CI: 2.15–20.83, p = 0.0013) and lower odds of complete occlusion (OR: 0.085, 95% CI: 0.024–0.26, p < 0.001) compared to non-BVAs.
- 66.7% of non-BVAs achieved complete occlusion without recurrence versus 20.0% of BVAs.
- Recurrence (OR: 5.55, 95% CI: 1.78–19.86, p= 0.005) and retreatment (OR: 4.44, 95% CI: 1.19–21.69, p= 0.034) rates were significantly higher in BVAs.
Interpretation:
Branch vessel involvement is a significant risk factor for unfavorable angiographic outcomes post-coiling, necessitating awareness and potential changes in treatment strategies, including intensified imaging surveillance and consideration of alternative treatment options.
Limitations:
- Retrospective nature of the study may introduce bias.
- Single-center study limits generalizability of findings.
Conclusion:
BVAs exhibit significantly worse long-term outcomes, highlighting the need for intensified imaging surveillance and consideration of alternative treatment strategies.
