Elective treatment of additional and recurrent aneurysms in patients with a previous subarachnoid hemorrhage: A single-center analysis of complications and clinical outcome.

Elective treatment of additional and recurrent aneurysms in patients with a previous subarachnoid hemorrhage: A single-center analysis of complications and clinical outcome.

World Neurosurg. 2019 Feb 19;:

Authors: Goertz L, Brinker G, Hamisch C, Kabbasch C, Borggrefe J, Hof M, Timmer M, Stavrinou P, Goldbrunner R, Krischek B

Abstract
OBJECTIVE: Subarachnoid hemorrhage (SAH) can be associated with a degree of resulting brain damage and subsequent reorganization of the central nervous system. The aim of this study was to evaluate complication rates and clinical outcome in patients with a previous subarachnoid haemorrhage (SAH) that were treated for a recurrent or an additional, initially unruptured aneurysm.
METHODS: A retrospective, single-center study was conducted for patients that underwent elective treatment by surgical or endovascular means between 2010 and 2018. We compared patients with a previous SAH and without history of SAH in terms of complication rates and functional outcomes (modified Rankin scale, mRS).
RESULTS: The study population consisted of 337 patients (non-SAH: 270, SAH: 67) that underwent 390 elective procedures for treatment of 443 aneurysms. Procedure-related complications occurred in 13.5% among patients with a previous SAH and in 13.3% among patients without SAH (p=1.0). At the 6-month follow-up, the morbidity rate (defined as any increase on the mRS scale) was comparable between the SAH group (6.7%) and the non-SAH group (7.6%, p=0.5). Overall favourable outcome (mRS score ≤ 2) was achieved by 96.6% in the SAH group and 97.3% in the non-SAH group (p=1.0). Also, in patients with a previous SAH, the choice of clipping or endovascular treatment did not have a significant impact on clinical outcome at the 6-month follow-up.
CONCLUSIONS: Treatment of recurrent or additional aneurysms in patients with a previous subarachnoid haemorrhage can be performed with acceptable complication and morbidity rates by either surgical or endovascular means.

PMID: 30794974 [PubMed - as supplied by publisher]

from A via a.sfakia on Inoreader https://ift.tt/2GZi1vF