Acutely ruptured intracranial saccular aneurysms treated with stent assisted coiling: complications and outcomes in 42 consecutive patients
Autor: | Minako Hayakawa, J C Chaloupka, Robert A. Taylor, R C Callison, C O Martin |
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Rok vydání: | 2011 |
Předmět: |
Adult
Male medicine.medical_specialty Subarachnoid hemorrhage medicine.medical_treatment Aneurysm Ruptured Asymptomatic Cohort Studies Modified Rankin Scale Antithrombotic medicine Humans cardiovascular diseases Prospective Studies Thrombus Aged Retrospective Studies Aged 80 and over business.industry Stent Vasospasm Intracranial Aneurysm General Medicine Middle Aged medicine.disease Embolization Therapeutic Surgery Radiography Treatment Outcome Cohort Acute Disease Female Stents Neurology (clinical) medicine.symptom business Follow-Up Studies |
Zdroj: | Journal of neurointerventional surgery. 2(1) |
ISSN: | 1759-8486 |
Popis: | Background Antiplatelet agents are required to prevent thromboembolic complications from recently deployed intracranial stents, yet they carry a risk of bleeding complications that may be serious in patients with recent subarachnoid hemorrhage. Method Consecutive patients at a single institution who had ruptured intracranial saccular aneurysms treated with stent assisted coiling were retrospectively reviewed. Our primary outcomes were ischemic stroke related to the stent and bleeding complications possibly related to antithrombotic therapy. Secondary outcomes included 3 month follow-up National Institute of Health Stroke Scale (NIHSS) scores and modified Rankin Scale (mRS) scores. Results 44 aneurysms in 42 patients were treated. Seven patients experienced ischemic strokes during their hospitalization. Five ischemic strokes were secondary to vasospasm; one was definitely related to thrombus formation within the stent and one was possibly related to the stent. Two patients had asymptomatic intracranial hemorrhages and one patient had a symptomatic intracranial hemorrhage. Patients with Hunt and Hess grades I–II (n=25) experienced no stent associated ischemic strokes or symptomatic intracranial hemorrhages. The two stent associated ischemic strokes and one symptomatic intracranial hemorrhage occurred in patients with Hunt and Hess grades III–V (n=17) and patients with external ventricular drains (EVDs) (n=17). Only one patient had disability at the 3 month follow-up that was possibly related to the stent (mRS score of 3 and NIHSS score of 2). Conclusion These data suggest that higher grade hemorrhage patients, especially those with EVDs, are at greater risk for ischemic stroke and/or bleeding complications than lower grade patients. However, the complications had a small impact on mid-term disability outcomes in this cohort. |
Databáze: | OpenAIRE |
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