====== Aneurysm occlusion ======

{{rss>https://pubmed.ncbi.nlm.nih.gov/rss/search/1hIuyCTdZ6arVp_FARbjq_IjJHfan0N3UfQsiYKXb6vuChcsv5/?limit=15&utm_campaign=pubmed-2&fc=20230615130841}}

The [[efficacy]] of [[intracranial aneurysm treatment]] (long-term [[success]] or [[effectiveness]] of the treatment) is measured by [[evidence]] of the [[aneurysm]] [[obliteration]] (failure to be demonstrated by conventional or noninvasive angiography), without evidence of [[aneurysm]] [[recanalization]] (any blood flow into the aneurysm) or [[aneurysm recurrence]] (reappearance).
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Despite advances in [[embolization device]]s, coiling of [[small intracranial aneurysm]]s is still scrutinized. High [[occlusion]] rates are achievable, especially in [[unruptured aneurysm]]s, with coil type and packing density suggesting an association with complete occlusion. Technical complications may be influenced by [[aneurysm geometry]]
((Begley SL, White TG, Shah KA, Turpin J, Toscano D, Dehdashti AR, Teron I, Link T, Patsalides A, Woo HH. A comparison of endovascular coil systems for the treatment of small intracranial aneurysms. Interv Neuroradiol. 2023 Jun 13:15910199231182456. doi: 10.1177/15910199231182456. Epub ahead of print. PMID: 37312530.)).
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Compared with [[pipeline embolization device]] (PED) alone, PED coiling could improve aneurysm occlusion. However, it could also increase the total [[complication]] risk, prolong procedure time, and increase the total [[cost]]. Compared with loose [[packing]], dense packing did not enhance the treatment effectiveness but increased the treatment cost.

Clinical relevance statement: The additional treatment effect from [[coiling]] embolization declines sharply after a certain point. Specifically, the aneurysm occlusion rate is roughly stable when the coil number is greater than 3 or the total coil length is longer than 150 cm
((Tong X, Han M, Xue X, Wu Z, Chen J, Liu A. Coiling embolization strategy for medium-to-giant-sized intracranial aneurysms treated with pipeline embolization device: a propensity score-weighted study. Eur Radiol. 2023 Jun 14. doi: 10.1007/s00330-023-09800-z. Epub ahead of print. PMID: 37314476.)).

===== Aneurysm recanalization =====

[[Aneurysm recanalization]].

===== Aneurysm recurrence =====

[[Aneurysm recurrence]].

===== Residual aneurysm =====

see [[Residual Aneurysm Neck]].

===== De novo aneurysm =====

[[de novo aneurysm]] formation
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Evidence of [[predictor]]s for [[intracranial aneurysm]] [[occlusion]] after treatment with [[flow diverter]]s is sparse. Current literature suggests that the absence of branch involvement, younger [[age]], and [[aneurysm]] [[diameter]] have the highest [[impact]] on [[aneurysm occlusion]] after treatment with [[flow diverter]]s. Large studies investigating high-quality data with well-defined [[inclusion criteria]] are needed for greater insight into [[flow diverter]] [[effectiveness]]
((Meyer L, Stracke CP, Bester M, Kallmes KM, Zeleňák K, Rouchaud A, Martínez-Galdámez M, Jabbour P, Nguyen TN, Siddiqui AH, Fiehler J, Gellissen S. Predictors of [[aneurysm]] [[occlusion]] after [[treatment]] with [[flow diverter]]s: a [[systematic literature review]]. J Neurointerv Surg. 2023 Jun 14:jnis-2022-019993. doi: 10.1136/jnis-2022-019993. Epub ahead of print. PMID: 37316195.)).

===== Incomplete clipping =====
[[Incomplete aneurysm clipping]].

===== Raymond-Roy Occlusion Classification =====

[[Raymond-Roy Occlusion Classification]].

===== Aneurysm Recanalization Stratification Scale =====

[[Aneurysm Recanalization Stratification Scale]].