Introduction: Ruptured intracranial aneurysm is an urgent diagnostic and therapeutic condition. Occlusion with coils is the first line treatment for ruptured aneurysms and also should be used to prevent re-rupture, po...Introduction: Ruptured intracranial aneurysm is an urgent diagnostic and therapeutic condition. Occlusion with coils is the first line treatment for ruptured aneurysms and also should be used to prevent re-rupture, potentially causing severe brain damage. Most aneurysms are subject to this type of treatment. The risk of intraoperative thromboembolic and haemorrhagic complications during treatment with coils is very low. Endovascular treatment with coils is therefore a safe and effective method that can prevent short and long-term haemorrhage. Short and long-term haemorrhage is achieved by early recanalization of cases with neuro-visualisation. Methods: In this article we present a retrospective analysis of the results of endovascular embolization of 137 patients, from 2017 to the present time, in three hospitals of Georgia country (Evex hospitals, New hospitals, New-vision University Hospital) with a diagnosis of acute subarachnoid haemorrhage. Results: In our study, overall postoperative mortality was reported to be 29.9% (41/137 patients). In 45 patients presenting with Hunt-Hess IV-V, the mortality rate was 51.1% (23/45). According to Raymond-Roy Scale, complete occlusion of aneurysm occurs in 66% of cases, residual occlusion of neck in 26%, and partial occlusion in 6%. Conclusion: Aneurysm rupture is an urgent clinical condition requiring rapid diagnosis and treatment. To prevent aneurysm re-rupture, operative intervention should be performed quickly. The recommended time interval is within 72 hours, and, if possible, within 24 hours after aneurysm rupture. Given the spasms typical of subarachnoid haemorraghe endovascular coiling of ruptured aneurysms is a first-line treatment that depends on the angioarchitecture and localization of the aneurysm. The main technique of endovascular treatment is occlusion by coils with or without remodeling balloon assistance. Generally, in acute periods, only aneurysms with coils are associated with relatively high rates of recanalization, so further observation and possible surgical treatment are recommended.展开更多
Background: Potentially lethal, aneurysmal subarachnoid hemorrhage has a bad prognosis for many individuals. Over the past few decades, endovascular and surgical interventions have been developed, including surgical c...Background: Potentially lethal, aneurysmal subarachnoid hemorrhage has a bad prognosis for many individuals. Over the past few decades, endovascular and surgical interventions have been developed, including surgical clipping, and endovascular coiling. Patients who have aSAH are also susceptible to delayed cerebral ischemia and cerebral vasospasm. The aim of this study is to compare the outcome of endovascular coiling with surgical clipping in patients with SAH, specifically in relation to prevalence of vasospasm, in the country of Georgia. Method: In this study, we present a retrospective review of the outcomes of 217 patients with acute subarachnoid hemorrhage who underwent endovascular coiling or surgical clipping. The data were gathered from patients who are admitted to New Vision University Hospital and Caucasus Medical Center in Tbilisi, Georgia, between 2017 and 2022. Results: Vasospasm was prevalent in 217 of the patients who had aneurysmal rupture when they first appeared. Endovascular coiling or surgical clipping was used to treat aneurysmal rupture. In our sample, 24.81 percent of patients who underwent coiling experienced vasospasm after 14 days, compared to 31.25 percent of patients who underwent clipping. After endovascular coiling and surgical clipping, the severity of vasospasm was only slightly different, according to Lindegaard ratios. Finally, 32 patients (23.35 percent) died after coiling whereas 55 patients (68.75 percent) died within three decades of clipping. Conclusion: After 5 years of data collection, this study has demonstrated the most favorable option for treatment is endovascular coiling. However, the treatment choice takes multiple factors into account, and clipping is not ideal for some ruptured aneurysms. Despite the fact that endovascular coiling is usually successful and minimally invasive, complications can occur and additional monitoring and potential surgical intervention are indicated.展开更多
文摘Introduction: Ruptured intracranial aneurysm is an urgent diagnostic and therapeutic condition. Occlusion with coils is the first line treatment for ruptured aneurysms and also should be used to prevent re-rupture, potentially causing severe brain damage. Most aneurysms are subject to this type of treatment. The risk of intraoperative thromboembolic and haemorrhagic complications during treatment with coils is very low. Endovascular treatment with coils is therefore a safe and effective method that can prevent short and long-term haemorrhage. Short and long-term haemorrhage is achieved by early recanalization of cases with neuro-visualisation. Methods: In this article we present a retrospective analysis of the results of endovascular embolization of 137 patients, from 2017 to the present time, in three hospitals of Georgia country (Evex hospitals, New hospitals, New-vision University Hospital) with a diagnosis of acute subarachnoid haemorrhage. Results: In our study, overall postoperative mortality was reported to be 29.9% (41/137 patients). In 45 patients presenting with Hunt-Hess IV-V, the mortality rate was 51.1% (23/45). According to Raymond-Roy Scale, complete occlusion of aneurysm occurs in 66% of cases, residual occlusion of neck in 26%, and partial occlusion in 6%. Conclusion: Aneurysm rupture is an urgent clinical condition requiring rapid diagnosis and treatment. To prevent aneurysm re-rupture, operative intervention should be performed quickly. The recommended time interval is within 72 hours, and, if possible, within 24 hours after aneurysm rupture. Given the spasms typical of subarachnoid haemorraghe endovascular coiling of ruptured aneurysms is a first-line treatment that depends on the angioarchitecture and localization of the aneurysm. The main technique of endovascular treatment is occlusion by coils with or without remodeling balloon assistance. Generally, in acute periods, only aneurysms with coils are associated with relatively high rates of recanalization, so further observation and possible surgical treatment are recommended.
文摘Background: Potentially lethal, aneurysmal subarachnoid hemorrhage has a bad prognosis for many individuals. Over the past few decades, endovascular and surgical interventions have been developed, including surgical clipping, and endovascular coiling. Patients who have aSAH are also susceptible to delayed cerebral ischemia and cerebral vasospasm. The aim of this study is to compare the outcome of endovascular coiling with surgical clipping in patients with SAH, specifically in relation to prevalence of vasospasm, in the country of Georgia. Method: In this study, we present a retrospective review of the outcomes of 217 patients with acute subarachnoid hemorrhage who underwent endovascular coiling or surgical clipping. The data were gathered from patients who are admitted to New Vision University Hospital and Caucasus Medical Center in Tbilisi, Georgia, between 2017 and 2022. Results: Vasospasm was prevalent in 217 of the patients who had aneurysmal rupture when they first appeared. Endovascular coiling or surgical clipping was used to treat aneurysmal rupture. In our sample, 24.81 percent of patients who underwent coiling experienced vasospasm after 14 days, compared to 31.25 percent of patients who underwent clipping. After endovascular coiling and surgical clipping, the severity of vasospasm was only slightly different, according to Lindegaard ratios. Finally, 32 patients (23.35 percent) died after coiling whereas 55 patients (68.75 percent) died within three decades of clipping. Conclusion: After 5 years of data collection, this study has demonstrated the most favorable option for treatment is endovascular coiling. However, the treatment choice takes multiple factors into account, and clipping is not ideal for some ruptured aneurysms. Despite the fact that endovascular coiling is usually successful and minimally invasive, complications can occur and additional monitoring and potential surgical intervention are indicated.
