Looks like a lot of research needs to be done to prevent these complications. If we had a great stroke association we could add this in the overall stroke recovery strategy. BUT WE HAVE NO STROKE LEADERSHIP OR STRATEGY.
Abstract
Background
Flow diversion of acutely ruptured intracranial aneurysms (IAs) is
controversial due to high treatment-related complication rates and a
lack of supporting evidence. We present clinical and radiological
results of the largest series to date.
Methods
This is a nationwide retrospective study of acutely ruptured IAs
treated with flow diverters (FDs). The primary outcome was the modified
Rankin Scale (mRS) score at the last available follow-up time. Secondary
outcomes were treatment-related complications and the aneurysm
occlusion rate.
Results
110 patients (64 females; mean age 55.7 years; range 12–82 years) with
acutely ruptured IAs were treated with FDs between 2012 and 2020 in five
centers. 70 acutely ruptured IAs (64%) were located in anterior
circulation, and 47 acutely ruptured IAs (43%) were blister-like. A
favorable functional outcome (mRS 0–2) was seen in 73% of patients
(74/102). Treatment-related complications were seen in 45% of patients
(n=49). Rebleeding was observed in 3 patients (3%). The data from
radiological follow-ups were available for 80% of patients (n=88), and
complete occlusion was seen in 90% of aneurysms (79/88). The data from
clinical follow-ups were available for 93% of patients (n=102). The
overall mortality rate was 18% (18/102).
Conclusions
FD treatment yields high occlusion for acutely ruptured IAs but is
associated with a high risk of complications. Considering the high
mortality rate of aneurysmal subarachnoid hemorrhage, the prevention of
rebleeding is crucial. Thus, FD treatment may be justified as a last
resort option.
Data availability statement
Data are not available for public, however upon a reasonable request it may be provided.
http://creativecommons.org/licenses/by-nc/4.0/This
is an open access article distributed in accordance with the Creative
Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits
others to distribute, remix, adapt, build upon this work
non-commercially, and license their derivative works on different terms,
provided the original work is properly cited, appropriate credit is
given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
Abstract
Background
Flow diversion of acutely ruptured intracranial aneurysms (IAs) is controversial due to high treatment-related complication rates and a lack of supporting evidence. We present clinical and radiological results of the largest series to date.
Methods
This is a nationwide retrospective study of acutely ruptured IAs treated with flow diverters (FDs). The primary outcome was the modified Rankin Scale (mRS) score at the last available follow-up time. Secondary outcomes were treatment-related complications and the aneurysm occlusion rate.
Results
110 patients (64 females; mean age 55.7 years; range 12–82 years) with acutely ruptured IAs were treated with FDs between 2012 and 2020 in five centers. 70 acutely ruptured IAs (64%) were located in anterior circulation, and 47 acutely ruptured IAs (43%) were blister-like. A favorable functional outcome (mRS 0–2) was seen in 73% of patients (74/102). Treatment-related complications were seen in 45% of patients (n=49). Rebleeding was observed in 3 patients (3%). The data from radiological follow-ups were available for 80% of patients (n=88), and complete occlusion was seen in 90% of aneurysms (79/88). The data from clinical follow-ups were available for 93% of patients (n=102). The overall mortality rate was 18% (18/102).
Conclusions
FD treatment yields high occlusion for acutely ruptured IAs but is associated with a high risk of complications. Considering the high mortality rate of aneurysmal subarachnoid hemorrhage, the prevention of rebleeding is crucial. Thus, FD treatment may be justified as a last resort option.
Data availability statement
Data are not available for public, however upon a reasonable request it may be provided.
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
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