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Factors associated with rebleeding after coil embolization in patients with aneurysmal subarachnoid hemorrhage

OBJECTIVE: Aneurysmal subarachnoid hemorrhage (aSAH) has a high mortality rate, and hemorrhage amounts and perioperative rebleeding importantly determines prognosis. However, despite adequate treatment, prognosis is poor in many ruptured aneurysm cases. In this study, we identified and evaluated fac...

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Autores principales: Kim, Donghee, Pyen, Jinsu, Whang, Kum, Cho, Sungmin, Jang, Yeongyu, Kim, Jongyeon, Koo, Younmoo, Choi, Jongwook
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Cerebrovascular Surgeons and Korean NeuroEndovascular Society 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8984641/
https://www.ncbi.nlm.nih.gov/pubmed/34695883
http://dx.doi.org/10.7461/jcen.2021.E2021.05.006
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author Kim, Donghee
Pyen, Jinsu
Whang, Kum
Cho, Sungmin
Jang, Yeongyu
Kim, Jongyeon
Koo, Younmoo
Choi, Jongwook
author_facet Kim, Donghee
Pyen, Jinsu
Whang, Kum
Cho, Sungmin
Jang, Yeongyu
Kim, Jongyeon
Koo, Younmoo
Choi, Jongwook
author_sort Kim, Donghee
collection PubMed
description OBJECTIVE: Aneurysmal subarachnoid hemorrhage (aSAH) has a high mortality rate, and hemorrhage amounts and perioperative rebleeding importantly determines prognosis. However, despite adequate treatment, prognosis is poor in many ruptured aneurysm cases. In this study, we identified and evaluated factors related to perioperative rebleeding in patients with aSAH. METHODS: The medical and surgical records of 166 patients that underwent endovascular embolization for a ruptured cerebral aneurysm at a single institution from 2014 to 2016 were retrospectively analyzed to identify risk factors of rebleeding. All patients were examined for risk factors and evaluated for increased hemorrhage by brain computed tomography at 3 days after surgery. RESULTS: This series included 54 men (32.5%) and 112 women (67.5%) of mean age 58.3±14.3 years. After procedures, 26 patients (15.7%) experienced rebleeding, and 1 of these (0.6%) experienced an intraoperative aneurysmal rupture. External ventricular drainage (EVD) (odds ratio [OR] 5.389, [95% confidence interval (CI) 1.171-24.801]) and modified Fisher grade (OR 2.037, [95% CI 1.077-3.853]) were found to be independent risk factors of rebleeding, and perioperative rebleeding was strongly associated with patient outcomes (p<0.001). CONCLUSIONS: We concluded the rebleeding risk after aSAH is greater in patients with large hemorrhage amounts and a high pre-operative modified Fisher grade, and thus, we caution neurosurgeons should take care in such cases.
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spelling pubmed-89846412022-04-11 Factors associated with rebleeding after coil embolization in patients with aneurysmal subarachnoid hemorrhage Kim, Donghee Pyen, Jinsu Whang, Kum Cho, Sungmin Jang, Yeongyu Kim, Jongyeon Koo, Younmoo Choi, Jongwook J Cerebrovasc Endovasc Neurosurg Clinical Article OBJECTIVE: Aneurysmal subarachnoid hemorrhage (aSAH) has a high mortality rate, and hemorrhage amounts and perioperative rebleeding importantly determines prognosis. However, despite adequate treatment, prognosis is poor in many ruptured aneurysm cases. In this study, we identified and evaluated factors related to perioperative rebleeding in patients with aSAH. METHODS: The medical and surgical records of 166 patients that underwent endovascular embolization for a ruptured cerebral aneurysm at a single institution from 2014 to 2016 were retrospectively analyzed to identify risk factors of rebleeding. All patients were examined for risk factors and evaluated for increased hemorrhage by brain computed tomography at 3 days after surgery. RESULTS: This series included 54 men (32.5%) and 112 women (67.5%) of mean age 58.3±14.3 years. After procedures, 26 patients (15.7%) experienced rebleeding, and 1 of these (0.6%) experienced an intraoperative aneurysmal rupture. External ventricular drainage (EVD) (odds ratio [OR] 5.389, [95% confidence interval (CI) 1.171-24.801]) and modified Fisher grade (OR 2.037, [95% CI 1.077-3.853]) were found to be independent risk factors of rebleeding, and perioperative rebleeding was strongly associated with patient outcomes (p<0.001). CONCLUSIONS: We concluded the rebleeding risk after aSAH is greater in patients with large hemorrhage amounts and a high pre-operative modified Fisher grade, and thus, we caution neurosurgeons should take care in such cases. Korean Society of Cerebrovascular Surgeons and Korean NeuroEndovascular Society 2022-03 2021-10-26 /pmc/articles/PMC8984641/ /pubmed/34695883 http://dx.doi.org/10.7461/jcen.2021.E2021.05.006 Text en Copyright © 2022 by KSCVS and KoNES https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Article
Kim, Donghee
Pyen, Jinsu
Whang, Kum
Cho, Sungmin
Jang, Yeongyu
Kim, Jongyeon
Koo, Younmoo
Choi, Jongwook
Factors associated with rebleeding after coil embolization in patients with aneurysmal subarachnoid hemorrhage
title Factors associated with rebleeding after coil embolization in patients with aneurysmal subarachnoid hemorrhage
title_full Factors associated with rebleeding after coil embolization in patients with aneurysmal subarachnoid hemorrhage
title_fullStr Factors associated with rebleeding after coil embolization in patients with aneurysmal subarachnoid hemorrhage
title_full_unstemmed Factors associated with rebleeding after coil embolization in patients with aneurysmal subarachnoid hemorrhage
title_short Factors associated with rebleeding after coil embolization in patients with aneurysmal subarachnoid hemorrhage
title_sort factors associated with rebleeding after coil embolization in patients with aneurysmal subarachnoid hemorrhage
topic Clinical Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8984641/
https://www.ncbi.nlm.nih.gov/pubmed/34695883
http://dx.doi.org/10.7461/jcen.2021.E2021.05.006
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