Journal article
Gender Differences in Procedural Clinical Complications and Outcomes of Intracranial Aneurysms: Analysis of the Stroke Thrombectomy and Aneurysm Registry
Neurosurgery, Vol.94(3), pp.545-551
03/2024
DOI: 10.1227/neu.0000000000002695
PMID: 37747370
Abstract
BACKGROUND AND OBJECTIVES: Some studies have shown that female patients had a poorer prognosis after endovascular treatment for ruptured intracranial aneurysm than male patients. However, data have been sparse regarding differences in the periprocedural and perioperative complication rate with ruptured and unruptured intracranial aneurysms. METHODS: This retrospective cohort study used data from the Stroke Thrombectomy and Aneurysm Registry, a database of 9 institutions in the United States, Europe, and Asia. The study presented intracranial aneurysms after microsurgical and/or endovascular treatment from January 1, 2013, to December 31, 2022. The primary outcome was incidence of periprocedural cerebral infarction. Secondary outcomes were periprocedural intracranial hemorrhage, periprocedural mortality, perioperative vasospasm, and functional outcome at 90 days after procedure. RESULTS: Among 3342 patients with aneurysm, 2447 were female and 857 were male, and the mean age of female and male patients was 59.6 and 57.1 years, respectively. Current smoker, family history of aneurysm, and ruptured aneurysm were observed in 23.5% vs 35.7 %, 10.8 % vs 5.7%, and 28.2% vs 40.5% of female and male patients, respectively. In female patients, internal carotid artery aneurysms were more commonly observed (31.1% vs 17.3%); however, anterior cerebral artery aneurysms were less commonly observed (18.5% vs 33.8%) compared with male patients. Periprocedural cerebral infarction rate was lower in female than male patients (2.4% vs 4.4%; P = .002). The adjusted odds ratio of primary outcome of female to male patients was 0.72 (95% CI, 0.46-1.12). Incidence of periprocedural intracranial hemorrhage and periprocedural mortality and perioperative symptomatic vasospasm and functional outcome was similar in both groups. In subgroup analysis, periprocedural cerebral infarction due to microsurgical treatment occurred frequently in male patients while incidence in endovascular treatment was similar in both groups (interaction P = .005). CONCLUSION: This large multicenter registry of patients undergoing intracranial aneurysm treatment found that female patients were not at increased risk of perioperative complications.
Details
- Title: Subtitle
- Gender Differences in Procedural Clinical Complications and Outcomes of Intracranial Aneurysms: Analysis of the Stroke Thrombectomy and Aneurysm Registry
- Creators
- Kazutaka Uchida - Hyogo UniversityHidetoshi Matsukawa - Hyogo UniversityMohammad-Mahdi Sowlat - Medical University of South CarolinaSameh Samir Elawady - Medical University of South CarolinaAli Alawieh - Emory UniversityPascal Jabbour - Thomas Jefferson University HospitalJustin Mascitelli - The University of Texas Health Science Center at San AntonioMichael R. Levitt - University of WashingtonHugo Cuellar - Louisiana State University in ShreveportEdgar A. Samaniego - University of IowaPeter Kan - The University of Texas Medical Branch at GalvestonMark Moss - Washington Regional Medical CenterAlejandro M. Spiotta - Medical University of South CarolinaShinichi Yoshimura - Department of Neurosurgery, Hyogo Medical University, Nishinomiya, Japan
- Resource Type
- Journal article
- Publication Details
- Neurosurgery, Vol.94(3), pp.545-551
- DOI
- 10.1227/neu.0000000000002695
- PMID
- 37747370
- ISSN
- 0148-396X
- eISSN
- 1524-4040
- Grant note
- DOI: 10.13039/100020501, name: Penumbra; DOI: 10.13039/100008894, name: Stryker; name: Medtronic
- Language
- English
- Electronic publication date
- 09/25/2023
- Date published
- 03/2024
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984472659502771
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