Yonsei Med J.  2015 Mar;56(2):403-409. 10.3349/ymj.2015.56.2.403.

Incidence and Risk Factors for Rebleeding during Cerebral Angiography for Ruptured Intracranial Aneurysms

Affiliations
  • 1Department of Neurosurgery, Ajou University School of Medicine, Suwon, Korea.
  • 2Department of Neurosurgery, Keimyung University School of Medicine, Dongsan Medical Center, Daegu, Korea.
  • 3Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. ns.joonho.chung@gmail.com
  • 4Department of Neurosurgery, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.

Abstract

PURPOSE
The purpose was to evaluate the incidence and risk factors for rebleeding during cerebral angiography in ruptured intracranial aneurysms.
MATERIALS AND METHODS
Among 1896 patients with ruptured intracranial aneurysms between September 2006 and December 2013, a total of 11 patients who experienced rebleeding of the ruptured aneurysms during digital subtraction angiography (DSA) were recruited in this study.
RESULTS
There were 184 patients (9.7%) who had suffered rebleeding prior to the securing procedure. Among them, 11 patients experienced rebleeding during DSA and other 173 patients at a time other than DSA. Eight (72.7%) of the 11 patients experienced rebleeding during three-dimensional rotational angiography (3DRA). The incidence of rebleeding during DSA was 0.6% in patients with ruptured intracranial aneurysms. Multivariate logistic regression analysis showed that aneurysm location in anterior circulation [odds ratio=14.286; 95% confidence interval (CI), 1.877 to 250.0; p=0.048] and higher aspect ratio (odds ratio=3.040; 95% CI, 1.896 to 10.309; p=0.041) remained independent risk factors for rebleeding during DSA.
CONCLUSION
Ruptured aneurysms located in anterior circulation with a high aspect ratio might have the risk of rebleeding during DSA, especially during 3DRA.

Keyword

Cerebral angiography; intracranial aneurysm; rebleeding; subarachnoid hemorrhage

MeSH Terms

Adult
Aged
Aneurysm, Ruptured
Angiography, Digital Subtraction/*methods
Cerebral Angiography/*methods
Female
Humans
Imaging, Three-Dimensional/*methods
Incidence
Intracranial Aneurysm/epidemiology/*radiography/therapy
Intracranial Hemorrhages/*epidemiology
Male
Middle Aged
Recurrence
Risk Factors
Tomography, X-Ray Computed

Figure

  • Fig. 1 All pictures of patients with rebleeding during 3-dimensional rotational angiography.


Cited by  1 articles

Risk Factors for the Rupture of Bifurcation Intracranial Aneurysms Using CT Angiography
Guang-xian Wang, Dong Zhang, Zhi-ping Wang, Liu-qing Yang, Lei Zhang, Li Wen
Yonsei Med J. 2016;57(5):1178-1184.    doi: 10.3349/ymj.2016.57.5.1178.


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