The application of silent MRA in follow-up after intracranial aneurysm endovascular treatment.

Abstract

PurposeTo assess the diagnostic value of silent MRA in the follow-up of intracranial aneurysms (IA) post-endovascular treatment.MethodsFrom 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.ResultsA 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.ConclusionsSilent MRA shows significant potential for postoperative follow-up in endovascular therapy of aneurysms, particularly in interventions of coiling embolization, stent-assisted coiling, and FD.