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The authors evaluated a total of 426 unruptured aneurysms and 169 ruptured aneurysms that underwent coil embolization in their institution between January 2009 and December 2017. Recanalization occurred in 38 (8.9%) of 426 unruptured aneurysms and 37 (21.9%) of 169 ruptured aneurysms. The Modified Raymond-Roy Classification on DSA was used to categorize the recanalization type. In untreated recanalized aneurysms, class IIIb aneurysms ruptured significantly more frequently than class II and IIIa. In the ruptured group, the median follow-up term was 28.0 months. Retreatment for recanalization was performed in 16 aneurysms. Four of 21 untreated recanalized aneurysms (2.37% of total coiled aneurysms) ruptured. Class IIIb aneurysms ruptured significantly more frequently than class II and IIIa. Coiled aneurysms with class IIIb recanalization should undergo early retreatment because of an increased rupture risk.

The authors retrospectively reviewed a nationwide surveillance to identify risk factors contributing to complications and short-term clinical outcomes in the endovascular treatment of brain arteriovenous malformations. A total of 1042 endovascular procedures (788 patients) performed in 111 institutions from 2010 to 2014 were reviewed. Univariate analysis identified deep venous drainage, associated aneurysms, infratentorial location, and pre-radiosurgical embolization as statistically significant risk factors for complications. Multivariate analysis showed that embolization of brain arteriovenous malformations in the infratentorial location was significantly associated with complications.