Abstract
Purpose
To assess the diagnostic value of silent MRA in the follow-up of intracranial aneurysms (IA) post-endovascular treatment.
Methods
From March 2023 to March 2024, we retrospectively collected data on patients with IA who underwent endovascular intervention and received silent MRA follow-up. All images were anonymized and evaluated on a 5-point scale: 1 (not visible, strong artifacts); 2 (poor quality, numerous artifacts/blurring); 3 (acceptable quality, moderate artifacts/blurring); 4 (good quality, minor blur artifacts); 5 (very good quality, nearly equal to DSA). The quality and occlusion status of aneurysms were descriptively analyzed.
Results
A total of 451 patients with 475 IA treated at our hospital received silent MRA follow-up. The silent MRA showed 100% 5-point scores in the coil embolization group. In the stent-assisted group, 65.7% achieved a 5-point score, and in the flow-diverter (FD) group, 42.6%. The multiple telescopic stents group had only 7.1% with a 5-point score, while the intrasaccular flow disruption group had 55.6%, and the FD+ coil group had 40.7%. There were two cases of distal aneurysms: one A3 segment aneurysm scored 5 points on silent MRA while the other M3 segment aneurysm did not visualize the aneurysm artery. A ≥3 score was helpful for diagnosing postoperative recurrence, with rates of 100%, 97.8%, 87.9%, 57.1%, 88.9%, 85.2%, and 50% across the groups.
Conclusions
Silent MRA shows significant potential for postoperative follow-up in endovascular therapy of aneurysms, particularly in interventions of coiling embolization, stent-assisted coiling, and FD.
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