Document Detail

Initial primary endovascular treatment in the management of ruptured intracranial aneurysms: a prospective consecutive series.
MedLine Citation:
PMID:  17004084     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: From January 1998 to December 2002, endovascular treatment (EVT) was used as first intention in all patients with ruptured aneurysms. The objective of this study was to analyze the results of this therapeutic strategy. METHODS: Among 401 patients admitted with a subarachnoid hemorrhage (SAH), 73 (18%) had a nonaneurysmal perimesencephalic SAH, 28 were not explored by angiography due to very poor clinical status, and 28 with aneurysmal SAH were not treated due to poor clinical status. Thus, of the 300 patients with a proven aneurysmal SAH, 272 (83%) were treated. EVT was attempted in 230 patients and was successful in 222 (82%), and clipping was performed in 50 (18%). RESULTS: Finally, EVT was successful in 234 aneurysms (96.7%) in 222 patients out of 242 aneurysms in 230 patients (some of the patients were treated for more than one aneurysm in the same procedure). EVT-related morbidity occurred in ten patients (4.5%) and mortality in eight (3.6%). Rate of dependency or death (modified Rankin scale 3-5) was 24.5% at 26 months. Initially, complete aneurysm occlusion was obtained in 81%, a dog ear in 3.4%, a neck remnant in 8% and incomplete occlusion in 8.1% of the patients. At follow-up (mean 26 months), the occlusion rate remained stable at 75%. CONCLUSION: This consecutive prospective series shows that EVT can be performed routinely as first-intention treatment in most aneurysmal SAH. Using this therapeutic strategy, EVT was performed in 82% of patients with long-term clinical results similar to those of the ISAT study.
Mehdi Mejdoubi; Michel Gigaud; Michel Trémoulet; Jean-François Albucher; Christophe Cognard
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Publication Detail:
Type:  Journal Article     Date:  2006-09-27
Journal Detail:
Title:  Neuroradiology     Volume:  48     ISSN:  0028-3940     ISO Abbreviation:  Neuroradiology     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2006-11-28     Completed Date:  2007-09-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1302751     Medline TA:  Neuroradiology     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  899-905     Citation Subset:  IM    
Department of Neuroradiology, Hôpital Purpan, University of Toulouse, Toulouse, France.
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MeSH Terms
Aged, 80 and over
Aneurysm, Ruptured / therapy*
Chi-Square Distribution
Child, Preschool
Embolization, Therapeutic / methods*
Intracranial Aneurysm / therapy*
Middle Aged
Prospective Studies
Treatment Outcome

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