Impact of Very Small Aneurysm Size and Anterior Communicating Segment Location on Outcome after Aneurysmal Subarachnoid Hemorrhage.

Details

Serval ID
serval:BIB_698A0B35C35C
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Impact of Very Small Aneurysm Size and Anterior Communicating Segment Location on Outcome after Aneurysmal Subarachnoid Hemorrhage.
Journal
Neurosurgery
Author(s)
Roethlisberger M., Aghlmandi S., Rychen J., Chiappini A., Zumofen D.W., Bawarjan S., Stienen M.N., Fung C., D'Alonzo D., Maldaner N., Steinsiepe V.K., Corniola M.V., Goldberg J., Cianfoni A., Robert T., Maduri R., Saliou G., Starnoni D., Weber J., Seule M.A., Gralla J., Bervini D., Kulcsar Z., Burkhardt J.K., Bozinov O., Remonda L., Marbacher S., Lövblad K.O., Psychogios M., Bucher H.C., Mariani L., Bijlenga P., Blackham K.A., Guzman R.
Working group(s)
Swiss SOS group
ISSN
1524-4040 (Electronic)
ISSN-L
0148-396X
Publication state
Published
Issued date
01/02/2023
Peer-reviewed
Oui
Volume
92
Number
2
Pages
370-381
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
Very small anterior communicating artery aneurysms (vsACoA) of <5 mm in size are detected in a considerable number of patients with aneurysmal subarachnoid hemorrhage (aSAH). Single-center studies report that vsACoA harbor particular risks when treated.
To assess the clinical and radiological outcome(s) of patients with aSAH diagnosed with vsACoA after aneurysm treatment and at discharge.
Information on n = 1868 patients was collected in the Swiss Subarachnoid Hemorrhage Outcome Study registry between 2009 and 2014. The presence of a new focal neurological deficit at discharge, functional status (modified Rankin scale), mortality rates, and procedural complications (in-hospital rebleeding and presence of a new stroke on computed tomography) was assessed for vsACoA and compared with the results observed for aneurysms in other locations and with diameters of 5 to 25 mm.
This study analyzed n = 1258 patients with aSAH, n = 439 of which had a documented ruptured ACoA. ACoA location was found in 38% (n = 144/384) of all very small ruptured aneurysms. A higher in-hospital bleeding rate was found in vsACoA compared with non-ACoA locations (2.8 vs 2.1%), especially when endovascularly treated (2.1% vs 0.5%). In multivariate analysis, aneurysm size of 5 to 25 mm, and not ACoA location, was an independent risk factor for a new focal neurological deficit and a higher modified Rankin scale at discharge. Neither very small aneurysm size nor ACoA location was associated with higher mortality rates at discharge or the occurrence of a peri-interventional stroke.
Very small ruptured ACoA have a higher in-hospital rebleeding rate but are not associated with worse morbidity or mortality.
Keywords
Adult, Humans, Child, Subarachnoid Hemorrhage/diagnostic imaging, Subarachnoid Hemorrhage/surgery, Subarachnoid Hemorrhage/etiology, Treatment Outcome, Intracranial Aneurysm/complications, Intracranial Aneurysm/diagnostic imaging, Intracranial Aneurysm/surgery, Aneurysm, Ruptured/complications, Aneurysm, Ruptured/diagnostic imaging, Aneurysm, Ruptured/surgery, Radiography
Pubmed
Web of science
Create date
12/12/2022 12:12
Last modification date
31/10/2023 8:11
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