Document Detail


Early rebleeding after coiling of ruptured intracranial aneurysms.
MedLine Citation:
PMID:  20849318     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Early rebleeding after coiling of a ruptured intracranial aneurysm (IA) may cause disability or death. The incidence and predictors of early rebleeding have previously been sparsely investigated.
PURPOSE: To assess the incidence and risk factors of early rebleeding after coiling of a ruptured IA and to analyze the outcome of the patients suffering early rehemorrhage.
MATERIAL AND METHODS: The data of 194 consecutive acutely (within 3 days) coiled patients with saccular ruptured IAs were analyzed. Age, gender, hypertension, aneurysm multiplicity, Hunt et Hess (HH) grade, intracerebral hematoma (ICH), intraventricular hematoma (IVH), external ventricular drainage (EVD), aneurysm location and size, and the grade of the initial aneurysm occlusion were tested to find the risk factors for early rebleeding. The outcome of the patients suffering rehemorrhage was verified.
RESULTS: Early rebleeding after coiling occurred in 7 patients out of 194 (3.6%). The presence of an ICH at admission and HH grade 3–5 before coiling were significant risk factors for rebleeding. An early rehemorrhage appeared as an enlargement of the initial ICH in all of these patients. Six of seven patients had good outcome (Glasgow Outcome Scale, GOS, 3–5). Logistic regression analysis did not find any other statistically significant risk factors.
CONCLUSION: The incidence of early rebleeding after acutely coiled ruptured IA was 3.6%. Risk factors for post-procedural rehemorrhage were the presence of ICH on the initial CT and HH grade 3–5 before coiling. Early rebleeding appeared exclusively as an enlargement of the initial ICH and not an increased amount of blood in the subarachnoid space.
Authors:
Pekka Jartti; Juha-Matti Isokangas; Ari Karttunen; Airi Jartti; Marianne Haapea; Tatu Koskelainen; Osmo Tervonen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta radiologica (Stockholm, Sweden : 1987)     Volume:  51     ISSN:  1600-0455     ISO Abbreviation:  Acta Radiol     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-14     Completed Date:  2010-11-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706123     Medline TA:  Acta Radiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  1043-9     Citation Subset:  IM    
Affiliation:
Department of Diagnostic and Interventional Radiology, Oulu University Hospital, OYS, Finland. pekka.jartti@ppshp.fi
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Aneurysm, Ruptured / complications,  radiography,  therapy*
Cerebral Angiography
Embolization, Therapeutic / methods*
Female
Humans
Intracranial Aneurysm / complications,  radiography,  therapy*
Logistic Models
Male
Middle Aged
Recurrence
Risk Factors
Subarachnoid Hemorrhage / etiology*,  radiography,  therapy*
Tomography, X-Ray Computed
Treatment Outcome

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