title: A comparison of the outcome of aneurysmal subarachnoid haemorrhage before and after the introduction of an endovascular service.
abstract: There has been a rapid change from predominantly surgical to endovascular treatment of ruptured intracranial aneurysms giving the opportunity to assess change in patient outcome during this transition. We identified and followed 139 patients with subarachnoid haemorrhage (SAH) treated in the year prior to (group 1) and following (group 2) the introduction of an endovascular service in a retrospective, cross-sectional study. A total of 78.7% of patients in group 1 underwent surgical treatment, 10.7% underwent endovascular treatment and 10.7% received no treatment, whereas patients in group 2 received 29.7%, 65.7% and 4.7%, respectively. MRS scores were obtained in 91% of patients in group 1 and in 89% of patients in group 2. A total of 30.7% and 24.0% of patients had a poor outcome in groups 1 and 2 respectively (p=0.34). The overall change in the management of ruptured cerebral aneurysms in the post-International Subarachnoid Aneurysm Trial (ISAT) era has not significantly changed cross-sectional outcome, although absolute differences appear to reflect difference in outcome noted in the ISAT.
authors.affiliation: Department of Neurosurgery, Level G Jubilee Wing, Leeds General Infirmary, Great George Street, Leeds, West Yorkshire, UK. yahia27@hotmail.com
authors.forename: Yahia Z
authors.initials: YZ
authors.lastname: Al-Tamimi
authors.forename: Maleeha
authors.initials: M
authors.lastname: Ahmad
authors.forename: Sophie E
authors.initials: SE
authors.lastname: May
authors.forename: Mohammed H
authors.initials: MH
authors.lastname: Bholah
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Callear
authors.forename: Anthony
authors.initials: A
authors.lastname: Goddard
authors.forename: Audrey C
authors.initials: AC
authors.lastname: Quinn
authors.forename: Stuart A
authors.initials: SA
authors.lastname: Ross
mesh_terms: D001807:Blood Vessel Prosthesis; D003430:Cross-Sectional Studies; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000379:methods; D057510:Endovascular Procedures / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology / Q000601:surgery*; D012189:Retrospective Studies; D013345:Subarachnoid Hemorrhage / Q000601:surgery*; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000379:methods*