TITLE:
Impact of Introducing Endovascular Treatment on Acute Phase of Subarachnoid Haemorrhage Outcome
AUTHORS:
Mirza Khinikadze, Vladimer Tsikarishvili, Koka Gogichashvili, Lana Bokuchava
KEYWORDS:
Anurisms, Sah, Coiling, Rupture, Acute Phase
JOURNAL NAME:
World Journal of Neuroscience,
Vol.12 No.2,
March
31,
2022
ABSTRACT: 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.