Role of temporary arterial occlusion in subarachnoid hemorrhage outcomes: a prospective cohort study.

Autor:	Yoshikawa MH; Universidade de São Paulo - São Paulo (SP) - Brazil., Rabelo NN; Universidade de São Paulo - São Paulo (SP) - Brazil., Telles JPM; Universidade de São Paulo - São Paulo (SP) - Brazil., Pipek LZ; Universidade de São Paulo - São Paulo (SP) - Brazil., Barbosa GB; Universidade de São Paulo - São Paulo (SP) - Brazil., Barbato NC; Universidade de São Paulo - São Paulo (SP) - Brazil., Coelho ACSDS; Universidade de São Paulo - São Paulo (SP) - Brazil., Teixeira MJ; Universidade de São Paulo - São Paulo (SP) - Brazil., Figueiredo EG; Universidade de São Paulo - São Paulo (SP) - Brazil.
Jazyk:	angličtina
Zdroj:	Acta cirurgica brasileira [Acta Cir Bras] 2023 Dec 04; Vol. 38, pp. e387923. Date of Electronic Publication: 2023 Dec 04 (Print Publication: 2023).
DOI:	10.1590/acb387923
Abstrakt:	Purpose: Temporary arterial occlusion (TAO) is a widespread practice in the surgical treatment of intracranial aneurysms. This study aimed to investigate TAO's role during ruptured aneurysm clipping as an independent prognostic factor on short- and long-term outcomes. Methods: This prospective cohort included 180 patients with ruptured intracranial aneurysms and an indication of microsurgical treatment. Patients who died in the first 12 hours after admission were excluded. Results: TAO was associated with intraoperative rupture (IOR) (odds ratio - OR = 10.54; 95% confidence interval - 95%CI 4.72-23.55; p < 0.001) and surgical complications (OR = 2.14; 95%CI 1.11-4.07; p = 0.01). The group with TAO and IOR had no significant difference in clinical (p = 0.06) and surgical (p = 0.94) complications compared to the group that had TAO, but no IOR. Among the 111 patients followed six months after treatment, IOR, number of occlusions, and total time of occlusion were not associated with Glasgow Outcome Scale (GOS) in the follow-up (respectively, p = 0.18, p = 0.30, and p = 0.73). Among patients who underwent TAO, IOR was also not associated with GOS in the follow-up (p = 0.29). Conclusions: TAO was associated with IOR and surgical complications, being the latter independent of IOR occurrence. In long-term analysis, neither TAO nor IOR were associated with poor clinical outcomes.
Databáze:	MEDLINE
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