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Impact of coil embolization on overall management and outcome of patients with aneurysmal subarachnoid hemorrhage

Nilsson, Ola LU ; Säveland, Hans LU ; Ramgren, B; Cronqvist, Mats LU and Brandt, Lennart LU (2005) In Neurosurgery 57(2). p.216-222
Abstract
Objective: We report on the consequences of introducing coil embolization for the total management of and outcome in patients with subarachnoid hemorrhage (SAH). Methods: In southern Sweden, a prospective analysis of all patients with SAH of verified aneurysmal origin was conducted during the 3 years when coiling was gradually being introduced. The incidence of acute or chronic hydrocephalus, vasospasm, delayed ischemic deterioration, and outcome at 3 to 6 months after bleeding was analyzed. Results: Coiling of aneurysms was used progressively more compared with clipping during the study period. The number of patients subjected to coiling was 26 (36%) of 73 patients during calendar year 1997, 43 (53%) of 81 patients in 1999, and 55 (74%)... (More)
Objective: We report on the consequences of introducing coil embolization for the total management of and outcome in patients with subarachnoid hemorrhage (SAH). Methods: In southern Sweden, a prospective analysis of all patients with SAH of verified aneurysmal origin was conducted during the 3 years when coiling was gradually being introduced. The incidence of acute or chronic hydrocephalus, vasospasm, delayed ischemic deterioration, and outcome at 3 to 6 months after bleeding was analyzed. Results: Coiling of aneurysms was used progressively more compared with clipping during the study period. The number of patients subjected to coiling was 26 (36%) of 73 patients during calendar year 1997, 43 (53%) of 81 patients in 1999, and 55 (74%) of 74 patients in 2001 (P<0.0001). Gradually, more elderly patients were admitted a during the study period. Virtually all aneurysms located in the posterior circulation were treated by coil embolization, even at the start of the study, whereas aneurysms at all other locations were progressively more likely to be treated similarly. The incidence of hydrocephalus in the acute (average for all 3 yr, 39%) or chronic (16%) phase, vasospasm as measured by Doppler sonography (33%), and delayed ischemic deterioration (29%), as well as outcome at 3 to 6 months (61% good recovery, 13% deceased), did not change significantly during the study. The main cause of unfavorable outcome was the severity of the SAH. Conclusion: The increasing use of coil embolization for ruptured aneurysms in the anterior circulation did not have any significant impact on the overall incidence of SAH-related complications or outcome. The main determinant for outcome after SAH is still the severity of the SAH. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
outcome, embolization, cerebral aneurysm, coil, subarachnoid, hemorrhage, surgery
in
Neurosurgery
volume
57
issue
2
pages
216 - 222
publisher
Congress of Neurological Surgeons
external identifiers
  • pmid:16094148
  • wos:000231111200003
  • scopus:23244431658
ISSN
0148-396X
DOI
10.1227/01.NEU.0000166534.24968.F5
language
English
LU publication?
yes
id
11cb1b32-f285-4825-8577-303c0dc11f8e (old id 224831)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16094148&dopt=Abstract
date added to LUP
2007-08-15 13:33:38
date last changed
2017-01-01 04:50:19
@article{11cb1b32-f285-4825-8577-303c0dc11f8e,
  abstract     = {Objective: We report on the consequences of introducing coil embolization for the total management of and outcome in patients with subarachnoid hemorrhage (SAH). Methods: In southern Sweden, a prospective analysis of all patients with SAH of verified aneurysmal origin was conducted during the 3 years when coiling was gradually being introduced. The incidence of acute or chronic hydrocephalus, vasospasm, delayed ischemic deterioration, and outcome at 3 to 6 months after bleeding was analyzed. Results: Coiling of aneurysms was used progressively more compared with clipping during the study period. The number of patients subjected to coiling was 26 (36%) of 73 patients during calendar year 1997, 43 (53%) of 81 patients in 1999, and 55 (74%) of 74 patients in 2001 (P&lt;0.0001). Gradually, more elderly patients were admitted a during the study period. Virtually all aneurysms located in the posterior circulation were treated by coil embolization, even at the start of the study, whereas aneurysms at all other locations were progressively more likely to be treated similarly. The incidence of hydrocephalus in the acute (average for all 3 yr, 39%) or chronic (16%) phase, vasospasm as measured by Doppler sonography (33%), and delayed ischemic deterioration (29%), as well as outcome at 3 to 6 months (61% good recovery, 13% deceased), did not change significantly during the study. The main cause of unfavorable outcome was the severity of the SAH. Conclusion: The increasing use of coil embolization for ruptured aneurysms in the anterior circulation did not have any significant impact on the overall incidence of SAH-related complications or outcome. The main determinant for outcome after SAH is still the severity of the SAH.},
  author       = {Nilsson, Ola and Säveland, Hans and Ramgren, B and Cronqvist, Mats and Brandt, Lennart},
  issn         = {0148-396X},
  keyword      = {outcome,embolization,cerebral aneurysm,coil,subarachnoid,hemorrhage,surgery},
  language     = {eng},
  number       = {2},
  pages        = {216--222},
  publisher    = {Congress of Neurological Surgeons},
  series       = {Neurosurgery},
  title        = {Impact of coil embolization on overall management and outcome of patients with aneurysmal subarachnoid hemorrhage},
  url          = {http://dx.doi.org/10.1227/01.NEU.0000166534.24968.F5},
  volume       = {57},
  year         = {2005},
}