Aneurysmal subarachnoid haemorrhage: Results after introducing endovascular therapy in a medium-low volume centre

To evaluate the impact of introducing endovascular therapy for patients with aneurysmal subarachnoid haemorrhage (aSAH) in a medium-low volume centre. A retrospective observational study was conducted by comparing the clinical outcome of patients with aSAH before and after introducing endovascular t...

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Veröffentlicht in:Neurocirugía (Asturias, Spain) Spain), 2016-09, Vol.27 (5), p.207-219
Hauptverfasser: Delgado-López, Pedro David, López-Martínez, José Luis, Gero-Escapa, María, Martín-Alonso, Javier, Castaño-Blazquez, Miguel, Ossa-Echeverri, Sergio, Martín-Velasco, Vicente, Castilla-Díez, José Manuel
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Sprache:spa
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Zusammenfassung:To evaluate the impact of introducing endovascular therapy for patients with aneurysmal subarachnoid haemorrhage (aSAH) in a medium-low volume centre. A retrospective observational study was conducted by comparing the clinical outcome of patients with aSAH before and after introducing endovascular therapy in our centre. The main variables analysed were: type of treatment, hospital and late mortality, intra-procedural morbidity, rate of re-bleeding and vasospasm, and clinical outcome according to the Glasgow Outcome Score (GOS). Seventy-one patients were treated in two periods: 2010-2011 (32 patients; 19 clipped, 6 coiled, 7 untreated), and 2012-2013 (39 patients, 3 clipped, 34 coiled, 2 untreated). No significant differences were found in age, sex, clinical grade at admission, type and location of aneurysm, Fisher score, or in hospital mortality (28.1% vs 25.6%, P=.35), GOS (except for GOS 5: 43.37% vs 53.8%, P=.045), rate of hydrocephalus and rate of vasospasm. The second cohort obtained better results for aggregated GOS 1+2+3 (36.3% vs 43.75%, P=.034) and for GOS 4+5 (61.5% vs 56.25%, P=.078). The percentage of patients left untreated was significantly lower in the second period (5.1% vs 21.8%, P
ISSN:1130-1473
DOI:10.1016/j.neucir.2016.01.005