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Effect of aneurysm treatment modalities on cerebral vasospasm after aneurysmal subarachnoid hemorrhage.
MedLine Citation:
PMID:  22890654     Owner:  NLM     Status:  In-Data-Review    
Introduction: It is still controversial if the selection of treatment modality (clip or coil) affects cerebral vasospasm development following aneurysmal subarachnoid hemorrhage (SAH). Materials and Methods: We enrolled 579 SAH patients in the Prospective Registry of Subarachnoid Aneurysms Treatment project, and these patients were treated either microsurgically or endovascularly within 12 days of onset. The incidence of vasospasm was compared between patients treated with clipping and coiling. Results: Clipping (282 patients) was preferably performed for small aneurysms with a wide neck or middle cerebral artery aneurysms and was followed by cerebrospinal fluid drainage; coiling (297 patients) was preferred for older patients, larger, internal carotid artery and posterior circulation aneurysms, or treatment during a nonacute stage and more frequently followed by antithrombotic treatment. Univariate analyses showed that vasospasm-induced cerebral infarct occurred more frequently in clipped patients than in coiled patients, but this difference disappeared after multivariate analyses. Higher incidence of vasospasm-induced cerebral infarct after clipping was explained by the fact that clipping was selected more for the ruptured middle cerebral artery aneurysm with massive SAH or hematoma, in which vasospasm more frequently occurred. Conclusions: Treatment modalities (clip or coil) may not significantly affect the incidence of vasospasm.
Hidenori Suzuki; Waro Taki;
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta neurochirurgica. Supplement     Volume:  115     ISSN:  0065-1419     ISO Abbreviation:  Acta Neurochir. Suppl.     Publication Date:  2013  
Date Detail:
Created Date:  2012-08-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100962752     Medline TA:  Acta Neurochir Suppl     Country:  Austria    
Other Details:
Languages:  eng     Pagination:  99-105     Citation Subset:  IM    
Department of Neurosurgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan,
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