Ruptured posterior circulation aneurysms: epidemiology, patterns of care, and outcomes from the Swiss SOS national registry.

Détails

ID Serval
serval:BIB_FFA8B16ACA58
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Ruptured posterior circulation aneurysms: epidemiology, patterns of care, and outcomes from the Swiss SOS national registry.
Périodique
Acta neurochirurgica
Auteur(s)
Maduri R., Starnoni D., Rocca A., Bervini D., Zumofen D.W., Stienen M.N., Schatlo B., Fung C., Robert T., Seule M.A., Burkhardt J.K., Maldaner N., Rothlisberger M., Blackham K.A., Marbacher S., D'Alonzo D., Remonda L., Machi P., Gralla J., Bijlenga P., Saliou G., Ballabeni P., Levivier M., Messerer M., Daniel R.T.
Collaborateur(s)
Swiss SOS Group
Contributeur(s)
Zsolt K., Keller E., Regli L., Bozinov O., Finkenstädt S., Schöni D., Raabe A., Beck J., Goldberg J., Mariani L., Guzman R., Fandino J., Coluccia D., Alessandro C., Valsecchi D., Chiappini A., Venier A., Reinert M., Weber J., Ferrari A., Weyerbrock A., Hildebrandt G., Hlavica M., Pereira V.M., Corniola M., Schaller K.
ISSN
0942-0940 (Electronic)
ISSN-L
0001-6268
Statut éditorial
Publié
Date de publication
04/2019
Peer-reviewed
Oui
Volume
161
Numéro
4
Pages
769-779
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
The treatment of ruptured posterior circulation aneurysms remains challenging despite progresses in the endovascular and neurosurgical techniques.
To provide epidemiological characterization of subjects presenting with ruptured posterior circulation aneurysms in Switzerland and thereby assessing the treatment patterns and neurological outcomes.
This is a retrospective analysis of the Swiss SOS registry for patients with aneurysmal subarachnoid hemorrhage. Patients were divided in 3 groups (upper, lower, and middle third) according to aneurysm location. Clinical, radiological, and treatment-related variables were identified and their impact on the neurological outcome was determined.
From 2009 to 2014, we included 264 patients with ruptured posterior circulation aneurysms. Endovascular occlusion was the most common treatment in all 3 groups (72% in the upper third, 68% in the middle third, and 58.8% in the lower third). Surgical treatment was performed in 11.3%. Favorable outcome (mRS ≤ 3) was found in 56% at discharge and 65.7% at 1 year. No significant difference in the neurological outcome were found among the three groups, in terms of mRS at discharge (p = 0.20) and at 1 year (p = 0.18). High WFNS grade, high Fisher grade at presentation, and rebleeding before aneurysm occlusion (p = 0.001) were all correlated with the risk of unfavorable neurological outcome (or death) at discharge and at 1 year.
In this study, endovascular occlusion was the principal treatment, with a favorable outcome for two-thirds of patients at discharge and at long term. These results are similar to high volume neurovascular centers worldwide, reflecting the importance of centralized care at specialized neurovascular centers.
Mots-clé
Aneurysmal subarachnoid hemorrhage, Endovascular procedures, Hydrocephalus, Intracranial aneurysms, Intracranial vasospasm, Posterior circulation, Ruptured aneurysms
Pubmed
Web of science
Création de la notice
04/02/2019 11:47
Dernière modification de la notice
20/08/2019 17:29
Données d'usage