Computed tomography angiography spot sign predicts intraprocedural aneurysm rupture in subarachnoid hemorrhage.

Details

Serval ID
serval:BIB_1D599027925B
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Computed tomography angiography spot sign predicts intraprocedural aneurysm rupture in subarachnoid hemorrhage.
Journal
Acta neurochirurgica
Author(s)
Burkhardt J.K., Neidert M.C., Stienen M.N., Schöni D., Fung C., Roethlisberger M., Corniola M.V., Bervini D., Maduri R., Valsecchi D., Tok S., Schatlo B., Bijlenga P., Schaller K., Bozinov O., Regli L.
Working group(s)
Swiss SOS study group
Contributor(s)
Fathi A.R., Fandino J., Marbacher S., D'Alonzo D., Kerkeni H., Soleman J., Coluccia D., Muroi C., Danura H., Schmid N., Zumofen D., Röthlisberger M., Mariani L., Guzman R., Monsch A.U., Bläsi S., Fung C., Bervini D., Beck J., Raabe A., Goldberg J., Schöni D., Gralla J., Zweifel-Zehnder A., Gutbrod K., Müri R., Maduri R., Daniel R.T., Starnoni D., Messerer M., Levivier M., Beaud V., Valsecchi D., Arrighi M., Venier A., Reinert M., Kuhlen D.E., Robert T., Rossi S., Sacco L., Bijlenga P., Corniola M., Schaller K., Chicherio C., Seule M.A., Ferrari A., Weyerbrock A., Hlavica M., Fournier J.Y., Früh S., Schatlo B., Burkhardt J.K., Stienen M.N., Keller E., Regli L., Bozinov O., Maldaner N., Tok S., Neidert M.C., Brugger P., Mondadori C.
ISSN
0942-0940 (Electronic)
ISSN-L
0001-6268
Publication state
Published
Issued date
07/2017
Peer-reviewed
Oui
Volume
159
Number
7
Pages
1305-1312
Language
english
Notes
Publication types: Journal Article ; Multicenter Study
Publication Status: ppublish
Abstract
To analyze whether the computed tomography angiography (CTA) spot sign predicts the intraprocedural rupture rate and outcome in patients with aneurysmal subarachnoid hemorrhage (aSAH).
From a prospective nationwide multicenter registry database, 1023 patients with aneurysmal subarachnoid hemorrhage (aSAH) were analyzed retrospectively. Descriptive statistics and logistic regression analysis were used to compare spot sign-positive and -negative patients with aneurysmal intracerebral hemorrhage (aICH) for baseline characteristics, aneurysmal and ICH imaging characteristics, treatment and admission status as well as outcome at discharge and 1-year follow-up (1YFU) using the modified Rankin Scale (mRS).
A total of 218 out of 1023 aSAH patients (21%) presented with aICH including 23/218 (11%) patients with spot sign. Baseline characteristics were comparable between spot sign-positive and -negative patients. There was a higher clip-to-coil ratio in patients with than without aICH (both spot sign positive and negative). Median aICH volume was significantly higher in the spot sign-positive group (50 ml, 13-223 ml) than in the spot sign-negative group (18 ml, 1-416; p < 0.0001). Patients with a spot sign-positive aICH thus were three times as likely as those with spot sign-negative aICH to show an intraoperative aneurysm rupture [odds ratio (OR) 3.04, 95% confidence interval (CI) 1.04-8.92, p = 0.046]. Spot sign-positive aICH patients showed a significantly worse mRS at discharge (p = 0.039) than patients with spot sign-negative aICH (median mRS 5 vs. 4). Logistic regression analysis showed that the spot sign was an aICH volume-dependent predictor for outcome. Both spot sign-positive and -negative aICH patients showed comparable rates of hospital death, death at 1YFU and mRS at 1YFU.
In this multicenter data analysis, patients with spot sign-positive aICH showed higher aICH volumes and a higher rate of intraprocedural aneurysm rupture, but comparable long-term outcome to spot sign-negative aICH patients.

Keywords
Adult, Aged, Aneurysm, Ruptured/diagnostic imaging, Aneurysm, Ruptured/epidemiology, Aneurysm, Ruptured/etiology, Computed Tomography Angiography, Female, Humans, Intraoperative Complications/diagnostic imaging, Intraoperative Complications/epidemiology, Intraoperative Complications/etiology, Male, Middle Aged, Neurosurgical Procedures/adverse effects, Neurosurgical Procedures/methods, Subarachnoid Hemorrhage/complications, Subarachnoid Hemorrhage/diagnostic imaging, Subarachnoid Hemorrhage/surgery, Aneurysmal subarachnoid hemorrhage (aSAH), Computed tomography angiography (CTA) spot sign, Intracerebral hemorrhage (ICH), Intraprocedural aneurysma rupture
Pubmed
Web of science
Create date
29/01/2017 7:45
Last modification date
15/10/2020 10:37
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