CT and MR Imaging Findings and Their Implications in the Follow-up of Patients with Intracranial Aneurysms Treated with Endosaccular Occlusion with Onyx

. 2003 Apr;24(4):567–578.

Patient data

Patient, Aneurysm Location and Size^*	Calcification	Thrombus	Mass Effect^†	Tx/Repeat Tx^‡	Examinations after First Tx		New Lesion^¶	Follow-Up Angiography^#	Recanali- zation^**	MRA^††
Patient, Aneurysm Location and Size^*	Calcification	Thrombus	Mass Effect^†	Tx/Repeat Tx^‡	CT^§	MR Imaging^‖	New Lesion^¶	Follow-Up Angiography^#	Recanali- zation^**	MRA^††
1, R sc ICA, giant	Yes	Yes	Yes	Onyx16/ Onyx20 + S	2	3 (M)	No	Yes	Yes	Yes
2, R cav ICA, giant	Yes	No	Yes	Onyx20 + S/none	2	3 (M)	No	Yes	No	Yes
3
R cav ICA, small	No	No	No	Onyx20/onyx20	2	2 (NI)	No	Yes	Yes	Yes
R cav ICA, small	No	No	No	Onyx20/none	2	2 (NI)	No	Yes	No	Yes
4, R pcav ICA, giant	No	Yes	Yes	Onyx20 + S/none	1	1 (M)	Asymptomatic	No	NA	No
5, L cav ICA, large	No	No	No	Onyx20 + S/none	1	2 (H)	No	Yes	No	Yes
6, R sc ICA, small	No	No	No	Onyx20/none	1	1 (H)	No	Yes	No	Yes
7, R sc ICA, small	No	No	No	Onyx20/none	1	2 (H)	No	Yes	No	Yes
8, L cav ICA, large	No	No	No	Onyx20 + S/none	1	2 (M)	No	Yes	No	Yes
9, L sc ICA, small	No	No	No	Onyx20/none	1	1 (H)	Asymptomatic	Yes	Yes	Yes
10, L cav ICA, small	No	No	No	Onyx20/none	1	1 (NI)	No	Yes	No	No
11, L pcav ICA, giant	Yes	Yes	Yes	Onyx16/onyx20 + S	1	2 (M)	No	Yes	Yes	No
12, R cav ICA, giant	Yes	Yes	Yes	Onyx20 + S/none	1	2 (M)	No	Yes	No	Yes
13, L sc ICA, large	No	No	No	Onyx20 + S/none	1	0 (NA)	Hemorrhage	No	NA	No
14
Basilar tip, large	No	Yes	Yes	Onyx16/none	1	0 (NA)	No	No	NA	No
R sup cb, small	No	No	No	Onyx16/none	1	0 (NA)	No	No	NA	No
15, L sc ICA, large	No	No	No	Onyx20 + S/none	1	2 (H)	No	Yes	No	Yes
16, R p ICA, small	No	No	No	Onyx20 + S/none	1	1 (H)	No	No	NA	No
17, L sc ICA, giant	No	No	No	Onyx16/none	1	1 (H)	WS ischemia	Yes	No	Yes
18, R cav ICA, giant	Yes	Yes	No	Onyx20 + S/none	1	0 (NA)	WS ischemia	No	NA	No
19, R cav ICA, giant	No	Yes	No	Onyx16/none	2	0 (NA)	No	Yes	Yes	No
20, R cav ICA, large	No	No	No	Onyx16/none	2	0 (NA)	No	Yes	No	No
21, R sup cb, giant	Yes	Yes	Yes	Onyx16/none	1	2 (M)	Asymptomatic	Yes	Yes	No
22, R sc ICA, giant	Yes	Yes	Yes	Onyx20/onyx20 + S	3	2 (M)	No	Yes	Yes	Yes
23
L sc ICA, giant	No	No	No	Onyx20/none	1	0 (NA)	No	Yes	No	No
R cav ICA, small	No	No	No	Onyx20/none	1	0 (NA)	No	Yes	No	No
R sc ICA, small	No	No	No	Onyx20/none	1	0 (NA)	No	Yes	No	No
24, R sc ICA, small	No	No	No	Onyx20/none	1	0 (NA)	No	No	NA	No
25, L cav ICA, large	No	No	No	Onyx20/none	1	0 (NA)	No	No	NA	No
26, R pcav ICA, large	No	No	No	Onyx20 + S/none	0	1 (M)	No	Yes	No	Yes
27, R cav ICA, giant	No	No	Yes	Onyx16/none	1	1 (M)	Transient CCF	Yes	No	No
28, R cav ICA, giant	No	No	Yes	Onyx20 + S/none	1	2 (M)	Asymptomatic	Yes	No	Yes
29, R cav ICA, giant	No	No	Yes	Onyx20 + S/none	0	1 (M)	No	Yes	No	No
30, R sc ICA, large	No	No	No	Onyx20/none	1	1 (H)	Asymptomatic	Yes	No	Yes
31, R cav ICA, small	No	No	No	Onyx20/none	0	1 (NI)	No	Yes	No	Yes
32, R sc ICA, giant	No	No	No	Onyx20 + S/none	1	2 (H)	Asymptomatic	Yes	No	Yes
33, R sc ICA, large	No	No	No	Onyx20/none	1	1 (H)	Asymptomatic	Yes	No	No
34, L sc ICA, large	No	No	No	Onyx20/none	1	1 (H)	No	Yes	No	Yes
35, L pc ICA, large	No	Yes	No	Onyx20/onyx20 + S	1	1 (M)	No	Yes	Yes	No
36, L sc ICA, large	No	No	Yes	Onyx20/none	1	0 (NA)	No	Yes	No	No
37, L sc ICA, small	No	No	No	Onyx20/none	0	2 (H)	No	Yes	No	Yes
38, L sc ICA, giant	No	Yes	Yes	Onyx20/none	1	2 (M)	Asymptomatic	Yes	No	Yes
39, L pc ICA, large	No	No	No	Onyx20/none	0	1 (M)	No	Yes	No	No
40, R sc ICA, giant	No	No	No	Onyx20/none	0	2 (M)	No	Yes	No	Yes
41, L sc ICA, giant	No	No	Yes	Onyx20/none	1	0 (NA)	No	Yes	No	No
42, R sc ICA, large	No	No	Yes	Onyx20/none	1	2 (H)	No	Yes	No	Yes

Patients 13 and 14 died after receiving the treatment relevant or irrelevant to the endovascular therapy. Aneurysms in the following patients contained previously placed GDCs: 14 (basilar tip aneurysm), 19, 21, 38. Abbreviations: cav indicates cavernous segment; p, petrous; pcav, petrocavernous segment; sc, supraclinoid; and sub cb, superior cerebellar artery.

^†

In patient 22, edema around the aneurysm increased after treatment.

^‡

Onyx16 indicates 16% Onyx (16% EVOH, 84% DMSO); Onyx20, 20% Onyx (20% EVOH, 80% DMSO); and S, stent.

^§

In the following patients, the aneurysm was not completely filled with the polymer, as shown on the posttreatment CT scans: 1, 11, 12, 16, 19, 21, 22, 27, 28, 30. That is, the polymer was not cast in the exact shape of the aneurysm.

^‖

Data in parentheses are the MR appearances. H indicates hypointense; NA, not applicable because MR studies were not available; NI, not identified due to the small size; and M, mixed signal intensity.

^¶

Lesions appearing after treatment. CCF indicates caroticocavernous fistula; WS, watershed.

Follow-up angiography performed in the third month and/or at 1 year. (Simultaneous control examinations for sectional imaging were performed within 2 days.) No indicates that selective angiography had not been performed yet or that images were not available. That is, the treatment was recent and control imaging had not yet been performed or the patient had refused. Two patients died after treatment and did not undergo control angiography.

^**

Recanalization detected during selective control angiography.

^††

In the following patients, MRAs showed that the parent artery had decreased in diameter: 1, 2, 5, 8, 12, 26, 28, 40. In the following patients, MRAs, showed that the parent artery had no apparent signal intensity: 15, 17, 32, 38. In the following patients, MRA results were comparable to those of selective angiography: 3, 6, 7, 9, 17, 22, 30, 31, 34, 37, 42.