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Single-Center Experience of Surgical and Endovascular Treatment of Ruptured Intracranial Aneurysms.
MedLine Citation:
PMID:  21349958     Owner:  NLM     Status:  Publisher    
BACKGROUND AND PURPOSE: ISAT provided valuable data on patient outcome after endovascular coiling and surgical clipping of ruptured aneurysms. The purpose of this study was to retrospectively review the ≥1-year outcome (in terms of survival, independence, and rebleeding) of patients who were treated in a routine clinical setting. MATERIALS AND METHODS: Records of patients presenting with an SAH from a ruptured aneurysm between 2000 and 2008 were reviewed. The 403 patients who met the inclusion criteria harbored 443 treated aneurysms; 173 were managed surgically and 230 by endovascular means. Mean clinical follow-up was 33.9 months (range, 12-106 months). RESULTS: The pretreatment clinical condition according to the HH was significantly better in the surgically treated patients (P = .018). Death occurred in 11.6% after surgery and in 17.4% after endovascular treatment (P = .104). Of the surviving patients in the surgical and endovascular groups, 80.3% and 87.2%, respectively, were able to live independently with grades 0-2 on the mRS (P = .084). Complete aneurysm occlusion was achieved significantly more often after surgical treatment (P < .001). Rebleeding occurred in 3.1% and 2.3% of the patients after surgical treatment and endovascular coiling, respectively. The occurrence of a residual aneurysm at the end of a coiling procedure was significantly related to the frequency of rebleeding (P = .007). CONCLUSIONS: The management of patients with intracranial aneurysms in a routine clinical setting shows good and comparable rates of mortality and independence. Coiling results in lower rates of complete aneurysm occlusion. Postcoiling angiography showing a residual aneurysm is a good predictor of the risk of rebleeding.
E G Klompenhouwer; J T A Dings; R J van Oostenbrugge; S Oei; J T Wilmink; W H van Zwam
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-24
Journal Detail:
Title:  AJNR. American journal of neuroradiology     Volume:  -     ISSN:  1936-959X     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003708     Medline TA:  AJNR Am J Neuroradiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Departments of Radiology, Neurosurgery, Neurology, and Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands.
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