Vol 50, No 5 (2016)

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Early outcomes and perioperative complications of endovascular embolization in patients with aneurysmal SAH

Grzegorz Turek1, Andrzej Lewszuk2, Jan Kochanowicz3, Tomasz Lyson1, Justyna Zielinska-Turek3, Krzysztof Gorbacz1, Zenon Mariak1
DOI: 10.1016/j.pjnns.2016.06.002
Neurol Neurochir Pol 2016;50(5):342-348.

Abstract

Background

We still lack reliable data on the outcomes of endovascular coiling for ruptured cerebral aneurysms. As this is still an evolving technique, the outcomes of the procedures performed in the past and more recently cannot be directly compared. We present the early outcomes of endovascular coiling in a relatively large group of patients with ruptured intracranial aneurysms.

Method

The study included 190 consecutive patients (a total of 216 aneurysms) subjected to endovascular coiling in 2006–2013 (127 women aged 56±13 years and 63 men aged 50± 15 years). Up to 87.5% of the aneurysms were located within anterior circulation. Most patients presented with “mild to moderate” subarachnoid hemorrhages (85% of Hunt &Hess scores 1–3, and 72% of Fisher scores 1–3).

Results

Embolization was feasible in 176 (92.6%) patients. In 14 cases, the embolization was not attainable due to unfavorable anatomy of the aneurysm, intraoperative vasospasm and/or aneurysm rupture, or prolapse of a coil. Early complications related to the procedure were recorded in 23 (13.1%) patients. The most common perioperative complication was aneurysm rupture. All fatal complications occurred in patients with aneurysms located at the anterior circle of Willis. At the time of discharge, 126 patients scored 4 or 5 on the Glasgow Outcome Scale.

Conclusions

Endovascular embolization is an effective and relatively safe method for treatment of ruptured cerebral aneurysms. Complications related to the procedure are significantly less frequent in the case of vertebral-basilar complex aneurysms.

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Neurologia i Neurochirurgia Polska