title: INTRAOPERATIVE ANEURYSMAL RUPTURE: CLINICAL OUTCOME FOLLOWING OPEN SURGERY OR ENDOVASCULAR TREATMENT.
abstract: The aim of this study was to evaluate and compare the outcomes of intraoperative aneurysmal rupture in patients with subarachnoid hemorrhage undergoing open surgical or endovascular treatment. This retrospective study included 742 patients with aneurysmal subarachnoid hemorrhage treated at the Clinical Department of Neurosurgery, Clinical Center of Serbia, during a three-year period. Among them, 167 (31.15%) were treated by clipping and 33 (16.01%) by coiling in the early phase (≤72 hours). The overall outcome and pretreatment variables were analyzed for each group, including between-group difference according to the occurrence of intraoperative aneurysmal rupture. Intraoperative aneurysmal rupture occurred in 14.7% of microsurgical and 2.4% of endovascular procedures. It was more frequent in early procedures as compared with delayed procedures (27.5% and 9.7% vs. 2.2% and 1.1%, respectively). On the contrary, mortality rates were lower in the surgical group (11.4%) than in the endovascular one (60.0%). On the basis of the results obtained, it is concluded that intraoperative aneurysmal rupture is more frequent after open than after endovascular treatment, but clinical outcome is more favorable in the former group.
authors.forename: Novak
authors.initials: N
authors.lastname: Lakićević
authors.forename: Branko
authors.initials: B
authors.lastname: Prstojević
authors.forename: Lukas
authors.initials: L
authors.lastname: Rasulić
authors.forename: Ljiljana
authors.initials: L
authors.lastname: Vujotić
authors.lastname: Vukašinović Ivan
authors.forename: Biljana
authors.initials: B
authors.lastname: Miličić
authors.forename: Andrija
authors.initials: A
authors.lastname: Savić
authors.forename: Bojana
authors.initials: B
authors.lastname: Živković
authors.forename: Krešimir
authors.initials: K
authors.lastname: Rotim
authors.forename: Miroslav
authors.initials: M
authors.lastname: Samardžić
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured / Q000453:epidemiology*; D002648:Child; D015331:Cohort Studies; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology*; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D019635:Neurosurgical Procedures; D012189:Retrospective Studies; D055771:Serbia; D013345:Subarachnoid Hemorrhage / Q000601:surgery*; D055815:Young Adult