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.
基金:
National Natural Science FoundationNational Natural Science Foundation of China [81441038]; Natural Science Foundation of Beijing, ChinaBeijing Natural Science Foundation [7142032]; Specific Research Projects for Capital Health Development [2014-3-2044]
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
推荐引用方式(GB/T 7714):
Qian Zenghui,Feng Xin,Kang Huibin,et al.Ruptured Wide-Necked Aneurysms: Is Stent-Assisted Coiling During Posthemorrhage Days 4-10 Safe and Efficient?[J].WORLD NEUROSURGERY.2017,101:137-143.doi:10.1016/j.wneu.2016.10.063.
APA:
Qian, Zenghui,Feng, Xin,Kang, Huibin,Wen, Xiaolong,Xu, Wenjuan...&Liu, Aihua.(2017).Ruptured Wide-Necked Aneurysms: Is Stent-Assisted Coiling During Posthemorrhage Days 4-10 Safe and Efficient?.WORLD NEUROSURGERY,101,
MLA:
Qian, Zenghui,et al."Ruptured Wide-Necked Aneurysms: Is Stent-Assisted Coiling During Posthemorrhage Days 4-10 Safe and Efficient?".WORLD NEUROSURGERY 101.(2017):137-143