title: [Aneurysmal subarachnoid haemorrhage: Results after introducing endovascular therapy in a medium-low volume centre].
abstract: To evaluate the impact of introducing endovascular therapy for patients with aneurysmal subarachnoid haemorrhage (aSAH) in a medium-low volume centre.
  
  
  
  A retrospective observational study was conducted by comparing the clinical outcome of patients with aSAH before and after introducing endovascular therapy in our centre. The main variables analysed were: type of treatment, hospital and late mortality, intra-procedural morbidity, rate of re-bleeding and vasospasm, and clinical outcome according to the Glasgow Outcome Score (GOS).
  
  
  
  Seventy-one patients were treated in two periods: 2010-2011 (32 patients; 19 clipped, 6 coiled, 7 untreated), and 2012-2013 (39 patients, 3 clipped, 34 coiled, 2 untreated). No significant differences were found in age, sex, clinical grade at admission, type and location of aneurysm, Fisher score, or in hospital mortality (28.1% vs 25.6%, P=.35), GOS (except for GOS 5: 43.37% vs 53.8%, P=.045), rate of hydrocephalus and rate of vasospasm. The second cohort obtained better results for aggregated GOS 1+2+3 (36.3% vs 43.75%, P=.034) and for GOS 4+5 (61.5% vs 56.25%, P=.078). The percentage of patients left untreated was significantly lower in the second period (5.1% vs 21.8%, P<.01), as well as the rate of re-bleeding (0% vs 9.4%, P<.01). Patients were treated earlier (2.51 vs 3.95 days), and hospital and total stay were lower (15.2 and 24.6 vs 10.3 and 18 days) in the second period, these differences not reaching statistical significance.
  
  
  
  Endovascular therapy allowed treating more patients with aSAH, and with a lower re-bleeding rate. This led to a modest reduction in morbidity and mortality.
authors.affiliation: Servicio de Neurocirugía, Hospital Universitario de Burgos, Burgos, España. Electronic address: pedrodl@yahoo.com.
authors.forename: Pedro David
authors.initials: PD
authors.lastname: Delgado-López
authors.affiliation: Servicio de Radiología, Sección de Neurorradiología Intervencionista, Hospital Universitario de Burgos, Burgos, España.
authors.forename: José Luis
authors.initials: JL
authors.lastname: López-Martínez
authors.affiliation: Servicio de Cuidados Intensivos, Hospital Universitario de Burgos, Burgos, España.
authors.forename: María
authors.initials: M
authors.lastname: Gero-Escapa
authors.affiliation: Servicio de Neurocirugía, Hospital Universitario de Burgos, Burgos, España.
authors.forename: Javier
authors.initials: J
authors.lastname: Martín-Alonso
authors.affiliation: Servicio de Radiología, Sección de Neurorradiología Intervencionista, Hospital Universitario de Burgos, Burgos, España.
authors.forename: Miguel
authors.initials: M
authors.lastname: Castaño-Blazquez
authors.affiliation: Servicio de Cuidados Intensivos, Hospital Universitario de Burgos, Burgos, España.
authors.forename: Sergio
authors.initials: S
authors.lastname: Ossa-Echeverri
authors.affiliation: Servicio de Neurocirugía, Hospital Universitario de Burgos, Burgos, España.
authors.forename: Vicente
authors.initials: V
authors.lastname: Martín-Velasco
authors.affiliation: Servicio de Neurocirugía, Hospital Universitario de Burgos, Burgos, España.
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Castilla-Díez
mesh_terms: D004621:Embolization, Therapeutic; D006801:Humans; D006849:Hydrocephalus; D002532:Intracranial Aneurysm / Q000628:therapy*; D012189:Retrospective Studies; D013345:Subarachnoid Hemorrhage / Q000628:therapy*; D016896:Treatment Outcome
keywords: Aneurisma cerebral; Brain aneurysm; Clipaje; Clipping; Coiling; Embolización; Hemorragia subaracnoidea; Mortalidad; Mortality; Prognosis; Pronóstico; Subarachnoid haemorrhage