title: Ruptured Wide-Necked Aneurysms: Is Stent-Assisted Coiling During Posthemorrhage Days 4-10 Safe and Efficient?
abstract: BACKGROUND
  Recent studies have reported the use of stent-assisted coiling (SAC) for wide-necked aneurysms in patients with acute subarachnoid hemorrhage (SAH). This study attempted to determine whether it is safe and efficient to use SAC for wide-necked aneurysms during post-SAH days 4-10.
  
  
  METHODS
  We reviewed 126 consecutive patients with ruptured wide-necked aneurysms who underwent SAC. The patients were classified into the early cohort (SAC was performed within post-SAH days 0-3) and late cohort (SAC was performed within post-SAH days 4-10). Intergroup differences in patients' demographics, aneurysm features, angiographic vasospasm, periprocedural complications, and clinical and angiographic outcomes were analyzed.
  
  
  RESULTS
  Of the 126 study patients, there were 70 (55.6%) in the early cohort and 56 (44.4%) in the late cohort. Angiographic vasospasm was significantly more likely to occur in patients treated in the late cohort (P < 0.05). No difference (P > 0.05) in age, sex, hypertension, dichotomized Fisher grade, dichotomized Hunt-Hess score, aneurysm features, aneurysm location, or periprocedural complications was found between the cohorts. We followed up 112 patients, in whom clinical and angiographic results showed no statistical significance (P > 0.05) between the 2 cohorts. When the patients were divided based on the dichotomized modified Rankin Scale into the "good outcome" and "poor outcome" groups at 6 months follow-up, higher Hunt-Hess scores (P < 0.001) were the only independent risk factors for poor outcome on multivariate logistic regression analysis.
  
  
  CONCLUSIONS
  Patients with ruptured wide-necked aneurysms treated on posthemorrhage days 4-10 did not appear to have worse outcomes compared to patients treated on posthemorrhage days 0-3.
authors: Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China; Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors: Zenghui
authors: Z
authors: Qian
authors: Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China; Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors: Xin
authors: X
authors: Feng
authors: Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China; Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors: Huibin
authors: H
authors: Kang
authors: Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China; Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors: Xiaolong
authors: X
authors: Wen
authors: Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China; Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors: Wenjuan
authors: W
authors: Xu
authors: Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors: Fei
authors: F
authors: Zhao
authors: Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China; Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors: Chuhan
authors: C
authors: Jiang
authors: Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China; Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors: Zhongxue
authors: Z
authors: Wu
authors: Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China; Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors: Youxiang
authors: Y
authors: Li
authors: Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China; Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. Electronic address: liuaihuadoctor@163.com.
authors: Aihua
authors: A
authors: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D002533:Cerebral Angiography; D015331:Cohort Studies; D004621:Embolization, Therapeutic / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000601:surgery; D015607:Stents; D013345:Subarachnoid Hemorrhage / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Intracranial aneurysm; Ruptured wide-necked aneurysm; Stent-assisted coiling; Subarachnoid hemorrhage; Timing