Outcome and Prognostic Factors of Ruptured Middle Cerebral Artery Aneurysms Treated via Endovascular Approach: A Single-Center 11-Year Experience
| Autor: | Bo Hong, Yu Zhou, Pengfei Yang, Guoli Duan, Jianmin Liu, Qinghai Huang, Yibin Fang, Rui Zhao, Xiaoxi Zhang, Yi Xu, Qiang Li |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Subarachnoid hemorrhage Aneurysm Ruptured Single Center Brain Ischemia 03 medical and health sciences 0302 clinical medicine Aneurysm Hematoma Recurrence Modified Rankin Scale medicine.artery medicine Humans cardiovascular diseases Risk factor Aged Retrospective Studies Univariate analysis business.industry Endovascular Procedures Anticoagulants Intracranial Aneurysm Middle Aged Subarachnoid Hemorrhage Prognosis medicine.disease Embolization Therapeutic Cerebral Angiography Surgery Treatment Outcome 030220 oncology & carcinogenesis Middle cerebral artery Female Stents Neurology (clinical) business Platelet Aggregation Inhibitors 030217 neurology & neurosurgery |
| Zdroj: | World Neurosurgery. 133:e187-e196 |
| ISSN: | 1878-8750 |
| Popis: | Objective To investigate outcomes and prognostic factors of ruptured middle cerebral artery (MCA) aneurysms, treated via endovascular approach, with improving treatment materials and techniques. Patients and Methods A total of 185 consecutive patients, admitted with acutely ruptured MCA aneurysms and treated by endovascular methods between 2006 and 2016, were retrospectively reviewed. Their baseline characteristics, procedure-related complications, and angiographic and clinical outcomes were collected. Univariate analysis and logistic regression analysis were completed to identify any association between procedure-related complications or clinical outcomes and potential risk factors. Results Procedure-related complications occurred in 28 patients (15.1%), including aneurysm rebleeding in 7 (3.8%), hematoma expansion in 10 (5.4%), and ischemia in 13 (7.0%) (concurrent hemorrhage and ischemia in 2 patients), which resulted in morbidity/mortality of 7% and 1.4%. Final evaluations indicated that 153 patients (82.7%, 153/185) had a good outcome (modified Rankin Scale score 0–2). Among 120 (69.4%) who underwent angiographic follow-up, 89 (74.2%) were completely occluded and 20/120 (16.7%) were recanalized. Multivariate analysis of clinical outcome indicated that a high preoperative Hunt and Hess grade (IV–V), intrasylvian/intracerebral hematoma, and early period treatment (2006–2013) were associated with unfavorable outcomes. Conclusions Endovascular treatment for patients with ruptured middle cerebral artery aneurysms may offer favorable clinical and angiographic outcomes. With the evolution of treatment materials and updated techniques, treatment complications have become less common than previously reported in literature, and clinical outcomes have been improved in recent years. |
| Databáze: | OpenAIRE |
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