The impact of endovascular treatment on cerebral aneurysm outcome at Groote Schuur Hospital.
OBJECTIVE
Neuro-endovascular treatment was introduced at Groote Schuur Hospital in 2001. We sought to assess whether this has resulted in a change in overall outcomes for patients treated for cerebral aneurysms.


METHODS
Retrospective cohort study. The first cohort included cerebral aneurysm patients seen between 1994 and 1998 when only surgical treatment was available. The second cohort consisted of a group treated using both surgical and endovascular methods between 2002 and 2004.


METHODS
Patients with ruptured and unruptured aneurysms were included in the study.


METHODS
The Glasgow Outcome Score (GOS) wasused to assess outcome. The primary comparator between groups was major disability (GOS 3 and 2) and death (GOS 1).


RESULTS
Cohorts were comparable regarding age, sex and presenting clinical condition as assessed using the World Federation of Neurological Surgeons grading for subarachnoid haemorrhage. There was an absolute reduction in major disability and death of 16% in the later cohort where 55% of patients had endovascular treatment.


CONCLUSIONS
The option of endovascular treatment for cerebral aneurysms at Groote Schuur Hospital has allowed for more rapid treatment of patients, which has reduced morbidity and mortality from re-bleeding. We are also able to select the best treatment option for each patient and believe this has contributed to our improved results.
Taylor
Allan
A
Division of Neurosurgery, Department of Surgery, Groote Schuur Hospital and University of Cape Town.
Le Feuvre
David
D
D017542:Aneurysm, Ruptured / Q000150:complications / Q000401:mortality / Q000628:therapy*; D021721:Balloon Occlusion / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000401:mortality; D002423:Cause of Death; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003131:Combined Modality Therapy; D003399:Craniotomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D004621:Embolization, Therapeutic; D005260:Female; D023261:Glasgow Outcome Scale; D006785:Hospitals, University; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000401:mortality / Q000628:therapy*; D008297:Male; D008866:Microsurgery / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D008875:Middle Aged; D009017:Morbidity; D018579:Patient Selection; D012008:Recurrence; D012189:Retrospective Studies; D013019:South Africa / Q000453:epidemiology; D016896:Treatment Outcome