ArticleFrontiers in surgery2026
Presence of small and large branch vessels from intracranial aneurysms increases the risk of post-treatment recurrence and retreatment following endovascular coiling: insights from a propensity score-matched cohort.
Article in Frontiers in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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10 authors.
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Abstract
Objective: Aneurysms with involvement of a branch vessel within the sac represent a particularly challenging morphological feature in the context of coil embolization. The aim of this propensity score-matched cohort study was to determine the impact of branch vessel involvement on angiographic occlusion, clinical outcomes, recurrence, and retreatment after endovascular coiling. Methods: We conducted a single-center retrospective cohort study of intracranial aneurysms treated with conventional, balloon-assisted, or stent-assisted coiling. Propensity score matching was performed to reduce confounding. Packing density was computed using AngioSuite. Regression models were used to analyze immediate and final Raymond-Roy Occlusion Classification grade, recurrence, and retreatment in the matched cohort. Results: Out of 330 patients with 330 aneurysms, 39 aneurysms (11.8%) had branch involvement. Propensity score matching yielded 31 branch-involving aneurysms (BVAs) matched to 31 non-BVAs. Immediate Raymond-Roy grade (OR: 2.57, 95% CI: 0.96-7.13, Conclusion: BVAs exhibit significantly worse long-term angiographic outcomes with higher recurrence and retreatment rates. Branch vessel incorporation is an intrinsic risk factor for unfavorable angiographic durability post-coiling that warrants awareness and novel treatment strategies. Specifically, BVAs may warrant intensified imaging surveillance and consideration of neck-reconstruction strategies or primary clipping when branch vessel preservation is feasible.
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