title: A retrospective clinical and angiographic study of the coiling outcome of ruptured intracranial aneurysms.
abstract: 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.
authors.affiliation: Neurosurgery Department, Neurological Institute, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan. drmostafasaleh@yahoo.com
authors.forename: Mostafa Saleh
authors.initials: MS
authors.lastname: Melake
authors.forename: Munetaka
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Kensaku
authors.initials: K
authors.lastname: Yoshida
authors.forename: Hidenori
authors.initials: H
authors.lastname: Oishi
authors.forename: Hajime
authors.initials: H
authors.lastname: Arai
authors.forename: Mohamed
authors.initials: M
authors.lastname: Elwan
authors.forename: Mohamed
authors.initials: M
authors.lastname: Okda
authors.forename: Wafik
authors.initials: W
authors.lastname: El-Sheikh
authors.forename: Tomokatsu
authors.initials: T
authors.lastname: Hori
mesh_terms: 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