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Ruptured Wide-Necked Aneurysms: Is Stent-Assisted Coiling During Posthemorrhage Days 4-10 Safe and Efficient?

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机构: [1]Capital Med Univ, Beijing Neurosurg Inst, Dept Intervent Neuroradiol, Beijing, Peoples R China; [2]Capital Med Univ, Beijing Tiantan Hosp, Dept Intervent Neuroradiol, Beijing, Peoples R China
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关键词: Intracranial aneurysm Ruptured wide-necked aneurysm Stent-assisted coiling Subarachnoid hemorrhage Timing

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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.

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出版当年[2016]版:
大类 | 3 区 医学
小类 | 3 区 临床神经病学 3 区 外科
最新[2023]版:
大类 | 4 区 医学
小类 | 4 区 临床神经病学 4 区 外科
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出版当年[2015]版:
Q1 SURGERY Q2 CLINICAL NEUROLOGY
最新[2023]版:
Q2 SURGERY Q3 CLINICAL NEUROLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2015版] 出版当年五年平均 出版前一年[2014版] 出版后一年[2016版]

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第一作者机构: [1]Capital Med Univ, Beijing Neurosurg Inst, Dept Intervent Neuroradiol, Beijing, Peoples R China; [2]Capital Med Univ, Beijing Tiantan Hosp, Dept Intervent Neuroradiol, Beijing, Peoples R China
通讯作者:
通讯机构: [1]Capital Med Univ, Beijing Neurosurg Inst, Dept Intervent Neuroradiol, Beijing, Peoples R China; [2]Capital Med Univ, Beijing Tiantan Hosp, Dept Intervent Neuroradiol, Beijing, Peoples R China
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