Large postoperative inflow area predictive of recurrence for paraclinoid aneurysms treated by simple coiling

Objectives: This study aims to investigate recurrence risk factors of simply coiled unruptured paraclinoid aneurysms based on a porous medium model (POM). Methods: Twenty unruptured coiled paraclinoid aneurysms with digital subtract angiography (DSA) follow-up were enrolled to analyze morphological and hemodynamic variables to predict recurrence. Results: Recurrent aneurysms have larger neck areas than stable aneurysms (34.43 +/- 21.46 mm(2) vs. 16.12 +/- 7.10 mm(2); p = 0.048). For hemodynamic variables, recurrent aneurysms had larger preoperative (16.40 +/- 11.38 mm(2) vs. 7.87 +/- 3.75 mm(2); p = 0.048) and postoperative inflow areas (14.07 +/- 6.80 mm(2) versus 6.73 +/- 4.20 mm(2); p = 0.021) than the stable group. Only the postoperative inflow area (p = 0.031, OR = 1.289; 95% CI 1.024-1.624) was an independent predictor of recurrence after multivariate regression analysis. The receiver operating characteristic (ROC) curve analysis efficiently predicted recurrence (AUC = 0.833, p = 0.021) with an inflow area cutoff value (9.15 mm(2); sensitivity, 0.833; specificity, 0.857). Conclusions: Neck area along with pre- and postoperative inflow areas were associated with aneurysm recurrence. These findings suggest that a large postoperative inflow area independently predicts the recurrence of coiled paraclinoid aneurysms.