Finnish flow diverter study: 8 years of experience in the treatment of acutely ruptured intracranial aneurysms.

Autor:	Alpay K; Department of Radiology, Turku University Hospital, Turku, Finland kemalp@utu.fi., Hinkka T; Department of Radiology, Tampere University Hospital, Tampere, Finland., Lindgren AE; Neurosurgery, Kuopio University Hospital, Kuopio, Pohjois-Savo, Finland.; Department of Clinical Radiology, Kuopio University Hospital, Kuopip, Finland.; University of Eastern Finland, Institute of Clinical Medicine, Kuopio, Finland., Isokangas JM; Oulu University Hospital, Oulu, Finland., Raj R; Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Uusimaa, Finland., Parkkola R; Department of Radiology, Turku University Hospital, Turku, Finland.; University of Turku, Turku, Finland., Sinisalo M; Department of Radiology, Turku University Hospital, Turku, Finland., Numminen J; Helsinki University Central Hospital, Helsinki, Uusimaa, Finland., Pienimäki JP; Department of Radiology, Tampere University Hospital, Tampere, Finland., Saari P; Kuopio University Hospital, Kuopio, Pohjois-Savo, Finland., Seppänen J; Department of Radiology, Tampere University Hospital, Tampere, Finland., Palosaari K; Oulu University Hospital, Oulu, Finland., Rautio R; Department of Radiology, Turku University Hospital, Turku, Finland.; University of Turku, Turku, Finland.
Jazyk:	angličtina
Zdroj:	Journal of neurointerventional surgery [J Neurointerv Surg] 2022 Jul; Vol. 14 (7), pp. 699-703. Date of Electronic Publication: 2021 Jul 15.
DOI:	10.1136/neurintsurg-2021-017641
Abstrakt:	Background: Flow diversion of acutely ruptured intracranial aneurysms (IAs) is controversial due to high treatment-related complication rates and a lack of supporting evidence. We present clinical and radiological results of the largest series to date. Methods: This is a nationwide retrospective study of acutely ruptured IAs treated with flow diverters (FDs). The primary outcome was the modified Rankin Scale (mRS) score at the last available follow-up time. Secondary outcomes were treatment-related complications and the aneurysm occlusion rate. Results: 110 patients (64 females; mean age 55.7 years; range 12-82 years) with acutely ruptured IAs were treated with FDs between 2012 and 2020 in five centers. 70 acutely ruptured IAs (64%) were located in anterior circulation, and 47 acutely ruptured IAs (43%) were blister-like. A favorable functional outcome (mRS 0-2) was seen in 73% of patients (74/102). Treatment-related complications were seen in 45% of patients (n=49). Rebleeding was observed in 3 patients (3%). The data from radiological follow-ups were available for 80% of patients (n=88), and complete occlusion was seen in 90% of aneurysms (79/88). The data from clinical follow-ups were available for 93% of patients (n=102). The overall mortality rate was 18% (18/102). Conclusions: FD treatment yields high occlusion for acutely ruptured IAs but is associated with a high risk of complications. Considering the high mortality rate of aneurysmal subarachnoid hemorrhage, the prevention of rebleeding is crucial. Thus, FD treatment may be justified as a last resort option. Competing Interests: Competing interests: KA has received personal research grants from Turku University Foundation and Maire Taponen Foundation. RRaj has received personal research grants from Finska Läkaresällskapet and Medicinska Understödsföreningen Liv & Hälsä. RR is consultant for Microvention, Stryker and Medtronic. (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu