Factors associated with rerupture of intracranial aneurysms after endovascular treatment: A retrospective review of 11 years experience at a single institution and review of the literature |
| |
| Affiliation: | 1. Department of Neurosurgery, University of Colorado Hospital, Aurora, CO, USA;2. Department of Radiology, University of Louisville, Louisville, KY, USA;3. Departments of Radiology and Neurosurgery, University of Colorado Hospital, Aurora, CO, USA;1. Department of Neurosurgery, University of Colorado Hospital, Aurora, CO, USA;2. Department of Radiology, University of Louisville, Louisville, KY, USA;3. Departments of Radiology and Neurosurgery, University of Colorado Hospital, Aurora, CO, USA;1. Department of Neurosurgery, K.E.M. Hospital and Seth G.S. Medical College, Parel, Mumbai, India;2. Lilavati Hospital and Research Centre, Bandra (E), Mumbai, India;1. Department of Orthopaedic Surgery, University of California, San Diego, La Jolla, CA;2. Department of Radiology, University of California, San Diego, La Jolla, CA;3. Department of Bioengineering, University of California, San Diego, La Jolla, CA;4. VA San Diego Healthcare System, San Diego, CA;1. Department of Neurosurgery, Hofstra Northwell School of Medicine, Hempstead, and Lenox Hill Hospital, New York, New York, USA;2. Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA;3. Department of Neurosurgery, Maimonides Medical Center, New York, New York, USA;1. Department of Neurosurgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, United States;2. Department of Neurosurgery, University of Utah School of Medicine, Salt Lake City, UT, United States;3. Department of Neurosurgery, Federal University of São Paulo, São Paulo, Brazil;4. Department of Neurosurgery, University of Minnesota, Minneapolis, MN, United States;1. Department of Neurosurgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China;2. Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China |
| |
| Abstract: | Aneurysm rebleeding following initial endovascular management is uncommon, and the factors associated with its occurrence are poorly defined. We retrospectively analyzed a consecutive series of patients presenting with aneurysmal subarachnoid hemorrhage who underwent endovascular management to determine factors associated with rebleeding. Rebleeding occurred in 7/183 (3.8%) patients, 6 of which had an adjacent hematoma on initial neuroimaging. Aneurysms were located on the ACoA (n = 5), PCoA (n = 1), and MCA (n = 1). Sizes ranged from 3.5 to 13.0 mm (mean 8.0), with neck sizes ranging from 1.8 to 4.6 mm (mean 3.2). Time-to-rerupture ranged from hours to years, with 3/7 cases rebleeding within 30 days and 4/7 cases rebleeding later than 30 days. Initial incomplete angiographic occlusion occurred in 2/3 cases of early rebleeding. The presence of adjacent intracerebral hematoma (ɸ = 0.354, p < 0.005), increasing Fisher Grade (t(9.4) = 7.72, p < 0.005), and aneurysmal outpouching (ɸ = 0.265, p < 0.005) were found to be the only factors associated with rerupture status. Recurrent hemorrhage following endovascular management of ruptured intracranial aneurysms is an uncommon but important source of morbidity, particularly in the early post-embolization period. The presence of high-risk features, such as an adjacent intracerebral hematoma or aneurysm outpouching, warrant early and frequent angiographic follow up to document stability and mitigate rupture risk. |
| |
| Keywords: | Subarachnoid hemorrhage Aneurysm Embolization Endovascular Rerupture Rebleeding Coil embolization |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
