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Endovascular coiling was originally approved by the Food and Drug Administration as a treatment for aneurysms that could not be surgically treated, but it has emerged as a first-line option for surgically accessible aneurysms as well.

"The downside to coiling," Ringer says, "is that while the risk is very low, it carries a higher rate of aneurysm recurrence than clipping. As a result, maintaining a watchful eye on the coiled aneurysm, through diagnostic angiography, is imperative."

Angiography is a minimally invasive test that allows specialists to look closely at arteries in the brain. It involves injecting a contrast dye into arteries, via a catheter, in order to make them visible.

Ringer, a neurosurgeon with the Mayfield Clinic, and colleagues reviewed data from patients who had undergone angiography surveillance of coiled aneurysms between January 2002 and December 2006. The UC-led study was the first ever to explore angiography risk solely among patients who had undergone coiling.

Previous studies of angiography have found complication risks among all patient groups ranging from 0.17 to 2.63 percent, the researchers reported. These studies included patients who were older and more likely to suffer complications, often because the test was being performed as a result of known or suspected cerebral blockage. The risk of stroke is among the most serious risks of angiography.

"As a subset of this overall group, patients undergoing angiography after endovascular coiling may be younger and healthier than patients in other angiogram risk studies," Ringer says. "The finding that their risk from surveillance angiography is lower than what has been found in studies of all patient groups confirms what we have seen in our medical practices." <
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