Results of Endovascular Treatment of Ruptured Intracranial Aneurysms and Recanalization Rate After a Five-Year Follow-Up Period.

Background/Objectives: Endovascular embolization of ruptured intracranial arterial aneurysms has become the first-choice treatment due to its minimal invasiveness, rapid patient recovery, and lower complication rate. The aim of this study was to analyze putative risk factors of unfavorable outcomes of ruptured intracranial aneurysms after coil embolization and the recanalization rate. Methods: This case series included adult patients with ruptured intracranial aneurysms who underwent endovascular embolization during the study period of 2007-2023. In total, 1080 patients with ruptured intracranial aneurysms treated using endovascular coiling participated in this study. Results: During the first year after the initial intervention, repeated embolization was performed for 50 patients (5.5%). Treatment outcome was assessed using the modified Rankin Scale, and neuroradiological follow-up was conducted during a five-year period on 672 patients. During the period from one to five years, re-embolization was performed in 11 (1.5%) cases, of which only three occurred during the last 3 years of follow-up. Conclusions: Endovascular embolization is a safe method for the treatment of ruptured intracranial aneurysms, with a low complication rate and good clinical outcome. Higher risk for repeated aneurysm embolization is associated with male sex, alcohol consumption, smoking, hyperlipidemia, aneurysm size, diabetes, aneurysm location, and obliteration rate. This study showed that aneurysms in which recanalization is not observed within 2 years after coil embolization remain stable during a follow-up period of 5 years, except in the case of large aneurysms and low obliteration rates.