Longitudinal radiological follow-up of individual level non-ischemic cerebral enhancing lesions following endovascular aneurysm treatment

• Published in: Journal of neurointerventional surgery Vol. 16; no. 8; pp. 838 - 845
• Main Authors: Guetarni, Zakaria, Bernard, Remy, Boulouis, Grégoire, Labeyrie, Marc-Antoine, Biondi, Alessandra, Velasco, Stéphane, Saliou, Guillaume, Bartolini, Bruno, Daumas-Duport, Benjamin, Bourcier, Romain, Janot, Kevin, Herbreteau, Denis, Michelozzi, Caterina, Premat, Kevin, Redjem, Hocine, Escalard, Simon, Bricout, Nicolas, Thouant, Pierre, Arteaga, Charles, Pierot, Laurent, Tahon, Florence, Boubagra, Kamel, Ikka, Leon, Chabert, Emmanuel, Lenck, Stephanie, Guédon, Alexis, Consoli, Arturo, Saleme, Suzana, Forestier, Géraud, Di Maria, Federico, Ferré, Jean-Christophe, Anxionnat, René, Eugene, Francois, Kerleroux, Basile, Dargazanli, Cyril, Sourour, Nader-Antoine, Clarençon, Frédéric, Shotar, Eimad
• Format: Journal Article
• Language: English
• Published: BMA House, Tavistock Square, London, WC1H 9JR BMJ Publishing Group Ltd 01.08.2024; BMJ Publishing Group LTD
• Subjects: Aged; Aneurysm; Aneurysms; Asymptomatic; Biopsy; Carotid arteries; Complication; Endovascular Procedures - adverse effects; Endovascular Procedures - methods; Female; Follow-Up Studies; Foreign bodies; Helium; Humans; Inflammatory Response; Intracranial Aneurysm - diagnostic imaging; Intracranial Aneurysm - surgery; Ischemia; Longitudinal Studies; Magnetic Resonance Imaging; Male; Middle age; Middle Aged; Neuroimaging; Patients; Questionnaires; Retrospective Studies; Software; Statistical analysis; Variables; France; Complication; Inflammatory Response; Aneurysm
• ISSN: 1759-8478; 1759-8486; 1759-8486
• DOI: 10.1136/jnis-2023-020060

BackgroundNon-ischemic cerebral enhancing (NICE) lesions following aneurysm endovascular therapy are exceptionally rare, with unknown longitudinal evolution.ObjectiveTo evaluate the radiological behavior of individual NICE lesions over time.MethodsPatients included in a retrospective national multicentric inception cohort were analyzed. NICE lesions were defined, using MRI, as delayed onset punctate, nodular, or annular foci enhancements with peri-lesion edema, distributed in the vascular territory of the aneurysm treatment, with no other confounding disease. Lesion burden and the longitudinal behavior of individual lesions were assessed.ResultsTwenty-two patients were included, with a median initial lesion burden of 36 (IQR 17–54) on the first MRI scan. Of the 22 patients with at least one follow-up MRI scan, 16 (73%) had new lesions occurring mainly within the first 200 weeks after the date of the procedure. The median number of new lesions per MRI was 6 (IQR 2–16). Among the same 22 patients, 7 (32%) had recurrent lesions. The median persistent enhancement of a NICE lesion was 13 weeks (IQR 6–30). No factor was predictive of early regression of enhancement activity with lesion regression kinetics mainly being patient-dependent.ConclusionsThe behavior of individual NICE lesions was found to be highly variable with an overall patient-dependent regression velocity.