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- Title
Imaging follow-up strategy after endovascular treatment of Intracranial aneurysms: A literature review and guideline recommendations.
- Authors
Yong-Hwan Cho; Jaehyung Choi; Chae-Wook Huh; Chang Hyeun Kim; Chul Hoon Chang; Soon Chan KWON; Young Woo Kim; Seung Hun Sheen; Sukh Que Park; Jun Kyeung Ko; Sung-kon Ha; Hae Woong Jeong; Hyen Seung Kang
- Abstract
Objective: Endovascular coil embolization is the primary treatment modality for intracranial aneurysms. However, its long-term durability remains of concern, with a considerable proportion of cases requiring aneurysm reopening and retreatment. Therefore, establishing optimal follow-up imaging protocols is necessary to ensure a durable occlusion. This study aimed to develop guidelines for follow-up imaging strategies after endovascular treatment of intracranial aneurysms. Methods: A committee comprising members of the Korean Neuroendovascular Society and other relevant societies was formed. A literature review and analyses of the major published guidelines were conducted to gather evidence. A panel of 40 experts convened to achieve a consensus on the recommendations using the modified Delphi method. Results: The panel members reached the following consensus: 1. Schedule the initial follow-up imaging within 3-6 months of treatment. 2. Noninvasive imaging modalities, such as three-dimensional time-of-flight magnetic resonance angiography (MRA) or contrast-enhanced MRA, are alternatives to digital subtraction angiography (DSA) during the first follow-up. 3. Schedule mid-term follow-up imaging at 1, 2, 4, and 6 years after the initial treatment. 4. If noninvasive imaging reveals unstable changes in the treated aneurysms, DSA should be considered. 5. Consider late-term follow-up imaging every 3-5 years for lifelong monitoring of patients with unstable changes or at high risk of recurrence. Conclusions: The guidelines aim to provide physicians with the information to make informed decisions and provide patients with high-quality care. However, owing to a lack of specific recommendations and scientific data, these guidelines are based on expert consensus and should be considered in conjunction with individual patient characteristics and circumstances.
- Subjects
LITERATURE reviews; ENDOVASCULAR surgery; MAGNETIC resonance angiography; DIGITAL subtraction angiography; INTRACRANIAL aneurysms; THERAPEUTIC embolization
- Publication
Journal of Cerebrovascular & Endovascular Neurosurgery, 2024, Vol 26, Issue 1, p1
- ISSN
2234-8565
- Publication type
Article
- DOI
10.7461/jcen.2024.E2023.08.008