Correlation Between Rupture or Retreatment and the Volume Embolization Ratio after Coil Embolization

Abstract

It is difficult to completely prevent rupture or the need for retreatment after coil embolization for saccular aneurysms. We retrospectively analyzed the correlation between rupture or retreatment and the volume embolization ratio (VER) after coil embolization, and used a receiver operating characteristic (ROC) curve analysis to determine the optimal cutoff value of the volume embolization ratio. Of the 289 embolized aneurysms, rupture and retreatment occurred in 23 (8.0%) and in nine (3.1%) aneurysms, respectively, during a follow-up period of 22.7 months. Rupture or retreatment tended to occur more frequently in ruptured aneurysms with a low VER (25%). An ROC curve based on the VER in ruptured aneurysms showed an AUC (area under the ROC curve) of 0.68 (95% confidence interval0.58-0.79). A VER cutoff value of 25% yielded optimal sensitivity and specificity (78.9%, 54.7%). There is a correlation between the rupture or retreatment and the VER after coil embolization in ruptured aneurysms. The optimal cutoff value of the VER for ruptured aneurysms is 25%.