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Comparison of Symptomatic Vasospasm after Surgical Clipping and Endovascular Coiling
Vasospasm, initial neurological damage, rebleeding, and periprocedural complications are associated prognostic factors for clinical outcomes after aneurysmal subarachnoid hemorrhage (SAH). In this study, factors related to delayed ischemic neurological deficit (DIND) are evaluated using data from ou...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Japan Neurosurgical Society
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9178112/ https://www.ncbi.nlm.nih.gov/pubmed/35418528 http://dx.doi.org/10.2176/jns-nmc.2021-0126 |
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author | IMAMURA, Hirotoshi TANI, Shoichi ADACHI, Hidemitsu FUKUMITSU, Ryu SUNOHARA, Tadashi FUKUI, Nobuyuki OMURA, Yoshihiro SASAKI, Natsuhi AKIYAMA, Tomoaki FUKUDA, Tatsumaru KAJIURA, Shinji SHIGEYASU, Masashi ASAKURA, Kento HORII, Ryo SAKAI, Nobuyuki |
author_facet | IMAMURA, Hirotoshi TANI, Shoichi ADACHI, Hidemitsu FUKUMITSU, Ryu SUNOHARA, Tadashi FUKUI, Nobuyuki OMURA, Yoshihiro SASAKI, Natsuhi AKIYAMA, Tomoaki FUKUDA, Tatsumaru KAJIURA, Shinji SHIGEYASU, Masashi ASAKURA, Kento HORII, Ryo SAKAI, Nobuyuki |
author_sort | IMAMURA, Hirotoshi |
collection | PubMed |
description | Vasospasm, initial neurological damage, rebleeding, and periprocedural complications are associated prognostic factors for clinical outcomes after aneurysmal subarachnoid hemorrhage (SAH). In this study, factors related to delayed ischemic neurological deficit (DIND) are evaluated using data from our institute for the last 18 years. Data from 2001 to 2018 of patients with aneurysmal SAH who underwent surgical clipping (SC) or endovascular coiling (EC) within 7 days of onset were retrospectively analyzed. Cases of mortality within 5 days after treatment were excluded. Multivariate analysis was used to identify the risk factors for DIND. In total, 840 cases of SAH were assessed; among these cases, 384 (45.7%) and 456 (54.3%) were treated with SC and EC, respectively. The frequency of DIND in the EC group was significantly less than that in the SC group (11.8% vs. 17.7%; p = 0.016). In the results of multivariate analysis, internal carotid artery (ICA) aneurysm and hemorrhagic complications were the risk factors for DIND. Cilostazol administration and EC were significant factors for vasospasm prevention after aneurysmal SAH (odds ratio of ICA aneurysm: 1.59, hemorrhagic complications: 1.76, SC: 1.51, and cilostazol administration: 0.51, respectively). Cilostazol administration was also a significant factor in patients who were treated with EC. ICA aneurysm, treatment strategy, hemorrhagic complications, and cilostazol administration were associated with DIND. Oral administration of cilostazol and avoiding hemorrhagic complications were effective in DIND prevention. If both treatments are available for ruptured aneurysms, clinicians should choose EC on the basis of its ability to prevent DIND. |
format | Online Article Text |
id | pubmed-9178112 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | The Japan Neurosurgical Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-91781122022-07-05 Comparison of Symptomatic Vasospasm after Surgical Clipping and Endovascular Coiling IMAMURA, Hirotoshi TANI, Shoichi ADACHI, Hidemitsu FUKUMITSU, Ryu SUNOHARA, Tadashi FUKUI, Nobuyuki OMURA, Yoshihiro SASAKI, Natsuhi AKIYAMA, Tomoaki FUKUDA, Tatsumaru KAJIURA, Shinji SHIGEYASU, Masashi ASAKURA, Kento HORII, Ryo SAKAI, Nobuyuki Neurol Med Chir (Tokyo) Original Article Vasospasm, initial neurological damage, rebleeding, and periprocedural complications are associated prognostic factors for clinical outcomes after aneurysmal subarachnoid hemorrhage (SAH). In this study, factors related to delayed ischemic neurological deficit (DIND) are evaluated using data from our institute for the last 18 years. Data from 2001 to 2018 of patients with aneurysmal SAH who underwent surgical clipping (SC) or endovascular coiling (EC) within 7 days of onset were retrospectively analyzed. Cases of mortality within 5 days after treatment were excluded. Multivariate analysis was used to identify the risk factors for DIND. In total, 840 cases of SAH were assessed; among these cases, 384 (45.7%) and 456 (54.3%) were treated with SC and EC, respectively. The frequency of DIND in the EC group was significantly less than that in the SC group (11.8% vs. 17.7%; p = 0.016). In the results of multivariate analysis, internal carotid artery (ICA) aneurysm and hemorrhagic complications were the risk factors for DIND. Cilostazol administration and EC were significant factors for vasospasm prevention after aneurysmal SAH (odds ratio of ICA aneurysm: 1.59, hemorrhagic complications: 1.76, SC: 1.51, and cilostazol administration: 0.51, respectively). Cilostazol administration was also a significant factor in patients who were treated with EC. ICA aneurysm, treatment strategy, hemorrhagic complications, and cilostazol administration were associated with DIND. Oral administration of cilostazol and avoiding hemorrhagic complications were effective in DIND prevention. If both treatments are available for ruptured aneurysms, clinicians should choose EC on the basis of its ability to prevent DIND. The Japan Neurosurgical Society 2022-04-12 /pmc/articles/PMC9178112/ /pubmed/35418528 http://dx.doi.org/10.2176/jns-nmc.2021-0126 Text en © 2022 The Japan Neurosurgical Society https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives International License. |
spellingShingle | Original Article IMAMURA, Hirotoshi TANI, Shoichi ADACHI, Hidemitsu FUKUMITSU, Ryu SUNOHARA, Tadashi FUKUI, Nobuyuki OMURA, Yoshihiro SASAKI, Natsuhi AKIYAMA, Tomoaki FUKUDA, Tatsumaru KAJIURA, Shinji SHIGEYASU, Masashi ASAKURA, Kento HORII, Ryo SAKAI, Nobuyuki Comparison of Symptomatic Vasospasm after Surgical Clipping and Endovascular Coiling |
title | Comparison of Symptomatic Vasospasm after Surgical Clipping and Endovascular Coiling |
title_full | Comparison of Symptomatic Vasospasm after Surgical Clipping and Endovascular Coiling |
title_fullStr | Comparison of Symptomatic Vasospasm after Surgical Clipping and Endovascular Coiling |
title_full_unstemmed | Comparison of Symptomatic Vasospasm after Surgical Clipping and Endovascular Coiling |
title_short | Comparison of Symptomatic Vasospasm after Surgical Clipping and Endovascular Coiling |
title_sort | comparison of symptomatic vasospasm after surgical clipping and endovascular coiling |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9178112/ https://www.ncbi.nlm.nih.gov/pubmed/35418528 http://dx.doi.org/10.2176/jns-nmc.2021-0126 |
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