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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japan Neurosurgical Society 2022
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.
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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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