Journal article
Acutely ruptured intracranial saccular aneurysms treated with stent assisted coiling: complications and outcomes in 42 consecutive patients
Journal of neurointerventional surgery, Vol.2(1), pp.23-30
03/2010
DOI: 10.1136/jnis.2009.001693
PMID: 21990554
Abstract
BackgroundAntiplatelet agents are required to prevent thromboembolic complications from recently deployed intracranial stents, yet they carry a risk of bleeding complications that may be serious in patients with recent subarachnoid hemorrhage.MethodConsecutive patients at a single institution who had ruptured intracranial saccular aneurysms treated with stent assisted coiling were retrospectively reviewed. Our primary outcomes were ischemic stroke related to the stent and bleeding complications possibly related to antithrombotic therapy. Secondary outcomes included 3 month follow-up National Institute of Health Stroke Scale (NIHSS) scores and modified Rankin Scale (mRS) scores.Results44 aneurysms in 42 patients were treated. Seven patients experienced ischemic strokes during their hospitalization. Five ischemic strokes were secondary to vasospasm; one was definitely related to thrombus formation within the stent and one was possibly related to the stent. Two patients had asymptomatic intracranial hemorrhages and one patient had a symptomatic intracranial hemorrhage. Patients with Hunt and Hess grades I–II (n=25) experienced no stent associated ischemic strokes or symptomatic intracranial hemorrhages. The two stent associated ischemic strokes and one symptomatic intracranial hemorrhage occurred in patients with Hunt and Hess grades III–V (n=17) and patients with external ventricular drains (EVDs) (n=17). Only one patient had disability at the 3 month follow-up that was possibly related to the stent (mRS score of 3 and NIHSS score of 2).ConclusionThese data suggest that higher grade hemorrhage patients, especially those with EVDs, are at greater risk for ischemic stroke and/or bleeding complications than lower grade patients. However, the complications had a small impact on mid-term disability outcomes in this cohort.
Details
- Title: Subtitle
- Acutely ruptured intracranial saccular aneurysms treated with stent assisted coiling: complications and outcomes in 42 consecutive patients
- Creators
- R A Taylor - Zeenat Qureshi Stroke Research Center, University of Minnesota, Minneapolis, Minnesota, USAR C Callison - Division of Neurointerventional Radiology, Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USAC O Martin - Saint Luke's Hospital, Kansas City, Missouri, USAM Hayakawa - Division of Neurointerventional Radiology, Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USAJ C Chaloupka - Division of Neurointerventional Radiology, Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
- Resource Type
- Journal article
- Publication Details
- Journal of neurointerventional surgery, Vol.2(1), pp.23-30
- DOI
- 10.1136/jnis.2009.001693
- PMID
- 21990554
- ISSN
- 1759-8478
- eISSN
- 1759-8486
- Language
- English
- Date published
- 03/2010
- Academic Unit
- Neurology; Radiology
- Record Identifier
- 9984020991002771
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