A retrospective clinical and angiographic study of the coiling outcome of ruptured intracranial aneurysms.
Many factors that determine the outcome of endovascular treatment of ruptured intracranial aneurysms are still controversial. We conducted a retrospective study of 203 patients with ruptured aneurysms treated by coiling to assess these factors. The Glasgow Outcome Scale score was used for clinical follow-up and magnetic resonance angiography for angiographic follow-up. Overall outcome and pretreatment variables predicting outcome were thoroughly analyzed. Good clinical grade on presentation was correlated with a better clinical outcome (p<0.001); however, symptomatic vasospasm (15.8% of patients) was correlated with a worse clinical outcome (p<0.001). Six patients (3%) suffered ischemic complications at the time of treatment, hemorrhagic events occurred in five patients (2.5%), permanent morbidity in five patients (2.5%) and overall mortality in 5.4%. In this series, we studied some factors currently debated in the literature and concluded that elderly patients (> or =65 years) with aneurysmal subarachnoid hemorrhage can safely be treated with endovascular therapy with a favorable outcome and that middle cerebral artery aneurysms can be safely embolized with results comparable to other locations.
Melake
Mostafa Saleh
MS
Neurosurgery Department, Neurological Institute, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan. drmostafasaleh@yahoo.com
Yamamoto
Munetaka
M
Yoshida
Kensaku
K
Oishi
Hidenori
H
Arai
Hajime
H
Elwan
Mohamed
M
Okda
Mohamed
M
El-Sheikh
Wafik
W
Hori
Tomokatsu
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery*; D016009:Chi-Square Distribution; D004621:Embolization, Therapeutic / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D023261:Glasgow Outcome Scale; D006261:Headache / Q000209:etiology; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery*; D018810:Magnetic Resonance Angiography / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011859:Radiography; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D020301:Vasospasm, Intracranial / Q000209:etiology