TITLE:
Vasospasm as a Complication after Aneurysmal Rupture and Its Relation with Surgical Clipping and Endovascular Coiling among a Georgian Sample
AUTHORS:
Maha Kassem, Lama Alchaar, Ahmed Abdelkader, Mohammad Eghbalbakhtiary, Koka Gogichashvili, Mirza Khinikadze, Shriniwas Chandrasekhar Yadav, Astha Zambani, Sonali Mankar, Mahalakshmi Jayasankar, Mohamed Abdelsattar Atta Ismail Ali, Sarah Ibrahim, Natia Iashvili
KEYWORDS:
Aneurysms, Subarachnoid Hemorrhage, Surgical Clipping, Endovascular Coiling, Vasospasm
JOURNAL NAME:
World Journal of Neuroscience,
Vol.12 No.3,
August
26,
2022
ABSTRACT: Background: Potentially lethal, aneurysmal subarachnoid hemorrhage has a bad
prognosis for many individuals. Over the past few decades, endovascular and
surgical interventions have been developed, including surgical clipping, and
endovascular coiling. Patients who have aSAH are also susceptible to delayed
cerebral ischemia and cerebral vasospasm. The aim of this study is to compare
the outcome of endovascular coiling with surgical clipping in patients with
SAH, specifically in relation to prevalence of vasospasm, in the country of
Georgia. Method: In this study, we present a retrospective review of the
outcomes of 217 patients with acute subarachnoid hemorrhage who underwent
endovascular coiling or surgical clipping. The data were gathered from patients
who are admitted to New Vision University Hospital and Caucasus Medical Center
in Tbilisi, Georgia, between 2017 and 2022. Results: Vasospasm was
prevalent in 217 of the patients who had aneurysmal rupture when they first
appeared. Endovascular coiling or surgical clipping was used to treat aneurysmal rupture. In our sample,
24.81 percent of patients who underwent coiling experienced vasospasm after 14
days, compared to 31.25 percent of patients who underwent clipping. After
endovascular coiling and surgical clipping, the severity of vasospasm was only
slightly different, according to Lindegaard ratios. Finally, 32 patients (23.35
percent) died after coiling whereas 55 patients (68.75 percent) died within
three decades of clipping. Conclusion: After 5 years of data collection,
this study has demonstrated the most favorable option for treatment is
endovascular coiling. However, the treatment choice takes multiple factors into
account, and clipping is not ideal for some ruptured aneurysms. Despite the
fact that endovascular coiling is usually successful and minimally invasive,
complications can occur and additional monitoring and potential surgical
intervention are indicated.