Document Detail


Rebleeding after endovascular embolization of ruptured cerebral aneurysms.
MedLine Citation:
PMID:  17965560     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study retrospectively reviewed 227 patients with ruptured solitary cerebral aneurysm who underwent endovascular embolization with detachable coils between March 1997 and March 2006 to establish the incidence of rebleeding after endovascular treatment for ruptured cerebral aneurysm and identify the risk factors. The site and size of the aneurysm, the interval between treatment and rebleeding, and the outcome were investigated in six of the 227 patients (2.6%) who rebled after treatment. Four patients had large or giant aneurysms located on the internal carotid artery at the origin of the posterior communicating artery. The interval between treatment and rebleeding was less than 1 year in four patients (mean 394.2 days). Two patients died, and the survivors had modified Rankin Scale scores of 0, 2, 3, and 4. Re-embolization was performed in four patients and no further bleeding occurred during the mean follow-up period of 1.9 years after re-treatment. Patients with giant aneurysms of the internal carotid artery are at increased risk for rebleeding. Re-treatment should be considered if there is conventional and/or magnetic resonance angiographic evidence of dome filling. Patients with ruptured cerebral aneurysms must be followed up with diagnostic imaging closely during the first 12 months post-embolization because rebleeding frequently occurs within 1 year after initial treatment. Re-embolization is safe and effective in patients with recurrent hemorrhage from aneurysms previously embolized with detachable coils.
Authors:
Hiroshi Aikawa; Kiyoshi Kazekawa; Shun-ichi Nagata; Masanari Onizuka; Minoru Iko; Masanori Tsutsumi; Tomonobu Kodama; Kouhei Nii; Syuko Matsubara; Housei Etou; Akira Tanaka
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurologia medico-chirurgica     Volume:  47     ISSN:  0470-8105     ISO Abbreviation:  Neurol. Med. Chir. (Tokyo)     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-10-29     Completed Date:  2008-01-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0400775     Medline TA:  Neurol Med Chir (Tokyo)     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  439-45; discussion 446-7     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Fukuoka University Chikushi Hospital, Chikushino, Fukuoka, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Aneurysm, Ruptured / complications,  radiography,  therapy*
Embolization, Therapeutic / adverse effects,  instrumentation,  methods*
Female
Follow-Up Studies
Humans
Intracranial Aneurysm / complications,  radiography,  therapy*
Magnetic Resonance Imaging
Male
Middle Aged
Postoperative Complications*
Recurrence
Reoperation
Retrospective Studies
Risk Assessment
Subarachnoid Hemorrhage*
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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