Impact of coil embolization on overall management and outcome of patients with aneurysmal subarachnoid hemorrhage

Research output: Contribution to journalArticle

Abstract

Objective: We report on the consequences of introducing coil embolization for the total management of and outcome in patients with subarachnoid hemorrhage (SAH). Methods: In southern Sweden, a prospective analysis of all patients with SAH of verified aneurysmal origin was conducted during the 3 years when coiling was gradually being introduced. The incidence of acute or chronic hydrocephalus, vasospasm, delayed ischemic deterioration, and outcome at 3 to 6 months after bleeding was analyzed. Results: Coiling of aneurysms was used progressively more compared with clipping during the study period. The number of patients subjected to coiling was 26 (36%) of 73 patients during calendar year 1997, 43 (53%) of 81 patients in 1999, and 55 (74%) of 74 patients in 2001 (P<0.0001). Gradually, more elderly patients were admitted a during the study period. Virtually all aneurysms located in the posterior circulation were treated by coil embolization, even at the start of the study, whereas aneurysms at all other locations were progressively more likely to be treated similarly. The incidence of hydrocephalus in the acute (average for all 3 yr, 39%) or chronic (16%) phase, vasospasm as measured by Doppler sonography (33%), and delayed ischemic deterioration (29%), as well as outcome at 3 to 6 months (61% good recovery, 13% deceased), did not change significantly during the study. The main cause of unfavorable outcome was the severity of the SAH. Conclusion: The increasing use of coil embolization for ruptured aneurysms in the anterior circulation did not have any significant impact on the overall incidence of SAH-related complications or outcome. The main determinant for outcome after SAH is still the severity of the SAH.

Details

Authors
  • Ola Nilsson
  • Hans Säveland
  • B Ramgren
  • Mats Cronqvist
  • Lennart Brandt
Organisations
Research areas and keywords

Subject classification (UKÄ)

  • Surgery
  • Neurology

Keywords

  • outcome, embolization, cerebral aneurysm, coil, subarachnoid, hemorrhage, surgery
Original languageEnglish
Pages (from-to)216-222
JournalNeurosurgery
Volume57
Issue number2
Publication statusPublished - 2005
Publication categoryResearch
Peer-reviewedYes

Bibliographic note

The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Clinic of Neurosurgery: University Hospital, Lund (LUR000009), Department of Clinical Sciences, Lund (013230000), Division IV (013230800)