Smokers at Increased Risk of Aneurysm Recurrence
FRIDAY March 28, 2008 -- Smokers with a brain aneurysm who are treated with coil embolization are more likely than other patients to develop another aneurysm, according to a U.S. study.
If a brain aneurysm bursts, the bleeding vessel causes a stroke.
During coil embolization, a catheter is inserted into an artery in the groin and then threaded to the affected area of the brain. One or more tiny coils are fed through the catheter and placed in the aneurysm. The body forms a blood clot around the coil, which blocks the aneurysm.
Neurological surgeons at Jefferson Hospital for Neuroscience in Philadelphia reviewed patient records from 2003 and found that cigarette smokers -- especially those with low-grade subarrachnoid hemorrhage -- who received this treatment were at increased risk for aneurysm recanalization (re-opening). The amount of cigarettes smoked affected the level of risk.
The researchers found no correlation between increased risk and aneurysm location and size, type of coil, or coil compaction.
The study -- believed to be the first to document a link between aneurysm recurrence and smoking -- was published in the April issue of the Journal of Neurosurgery.
"Of the various factors that lead to a predisposition for these cerebral aneurysms, cigarette smoking is the only factor that has consistently been identified in all the populations studied and is also the most easily preventable," Dr. Erol Veznedaroglu, an associate professor of neurological surgery and director of the division of neurovascular surgery and endovascular neurosurgery at Jefferson Medical College, said in a prepared statement.
The study authors noted that previous research had established a direct link between cigarette smoking and increased risk of brain aneurysm formation and growth, but "despite this evidence, more than one third of prior smokers continue to use nicotine after suffering an aneurysm, especially patients who started smoking at a young age and those with a history of depression or alcohol abuse."
While this study didn't find a significant association between smoking cessation and aneurysm recurrence, Veznedaroglu said "patients with known cerebral aneurysms should be aggressively counseled about the risk of cigarette smoking."
The Brain Aneurysm Foundation has more about treatment options.
Posted: March 2008