Faculty Collaboration Database

Impact of ruptured cerebral aneurysm coiling and clipping on the incidence of cerebral vasospasm and clinical outcome. J Neuroimaging 2009 Apr;19(2):144-9

Date

08/07/2008

Pubmed ID

18681928

DOI

10.1111/j.1552-6569.2008.00285.x

Scopus ID

2-s2.0-63149108599 (requires institutional sign-in at Scopus site)   21 Citations

Abstract

BACKGROUND: This study assessed the impact of treatment modality of aneurysmal subarachnoid hemorrhage (aSAH) on the rate of vasospasm (VSP), mortality, and hospital length of stay (LOS) of patients with aneurysmal subarachnoid hemorrhage (aSAH).

METHODS: We analyzed patients with aSAH admitted between 1999 and 2005 undergoing either endovascular coiling (EC) or surgical clipping (SC) within 72 hours of onset. Clinical VSP was defined as neurological deficits unexplained by another etiology. Radiological VSP was defined based on transcranial Doppler (TCD) ultrasound, digital subtraction angiography (DSA), and CT criteria. Bivariate and logistic regression analysis was used to determine VSP predictors.

RESULTS: Of 216 patients included, 98 (45%) underwent EC and 118 (55%) underwent SC. Clinical VSP was found in 26% of EC and 40% of SC patients (P < .03). TCD VSP, angiographic VSP, and CT infarctions were all significantly higher in the SC group. Mortality was similar in both groups however the LOS was longer in the SC patients (P= .03). Multivariate analysis showed that SC doubled the risk of clinical VSP (P < .03) and tripled the risk of composite VSP (P < .0006).

CONCLUSIONS: Our study reveals that EC has a lower rate of VSP, shorter LOS, and comparable mortality to SC in aSAH.

Author List

Zaidat OO, Ionita CC, Hussain SI, Alexander MJ, Friedman AH, Graffagnino C

MESH terms used to index this publication - Major topics in bold

Age Factors
Analysis of Variance
Aneurysm, Ruptured
Brain
Embolization, Therapeutic
Female
Humans
Incidence
Intracranial Aneurysm
Length of Stay
Logistic Models
Male
Middle Aged
Postoperative Complications
Radiography
Severity of Illness Index
Subarachnoid Hemorrhage
Time Factors
Treatment Outcome
Vasospasm, Intracranial