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Early outcomes and perioperative complications of endovascular embolization in patients with aneurysmal SAH
Affiliations- Department of Neurosurgery, Medical University of Bialystok, Poland
- Department of Radiology, Medical University of Bialystok, Bialystok, Poland
- Department of Invasive Neurology, Medical University of Bialystok, Bialystok, Poland
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Abstract
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.
MethodThe 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).
ResultsEmbolization 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.
ConclusionsEndovascular 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.
Abstract
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.
MethodThe 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).
ResultsEmbolization 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.
ConclusionsEndovascular 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.
Keywords
Cerebral aneurysm, Subarachnoid hemorrhage, Endovascular treatment, Coiling
About this articleTitle
Early outcomes and perioperative complications of endovascular embolization in patients with aneurysmal SAH
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
342-348
Page views
264
Article views/downloads
361
DOI
10.1016/j.pjnns.2016.06.002
Bibliographic record
Neurol Neurochir Pol 2016;50(5):342-348.
Keywords
Cerebral aneurysm
Subarachnoid hemorrhage
Endovascular treatment
Coiling
Authors
Grzegorz Turek
Andrzej Lewszuk
Jan Kochanowicz
Tomasz Lyson
Justyna Zielinska-Turek
Krzysztof Gorbacz
Zenon Mariak
