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 rapiddiagnosis 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
References
[1]
Association, A.H. (2019) Heart Disease and Stroke Statistics—2019 Update. American Heart Association, Dallas.
[2]
Broderick, J.P., Brott, T.G., Duldner, J.E., Tomsick, T. and Leach, A. (1994) Initial and Recurrent Bleeding Are the Major Causes of Death Following Subarachnoid Hemorrhage. Stroke, 25, 1342. https://doi.org/10.1161/01.STR.25.7.1342
[3]
Fischer, T., Johnsen, S.P., Pedersen, L., Gaist, D., Sorensen, H.T. and Rothman, K.J. (2005) Seasonal Variation in Hospitalization and Case Fatality of Subarachnoid Hemorrhage—A Nationwide Danish Study on 9,367 Patients. Neuroepidemiology, 24, 32–37. https://doi.org/10.1159/000081047
[4]
Christopher, S.O., Michelle, H.A. and Matthew, R.F. (2015) Stratification of Recanalization for Patients with Endovascular Treatment of Intracranial Aneurysms. Neurosurgery, 76, 390-395. https://doi.org/10.1227/NEU.0000000000000651
[5]
Harrigan, M.R. and Deveikis, J.P. (2019) Handbook of Cerebrovascular Disease and Neurointerventional Technique. https://doi.org/10.1007/978-3-319-66779-9
[6]
Labovitz, D.L., Halim, A.X., Brent, B., Boden-Albala, B., Hauser, W.A. and Sacco, R.L. (2006) Subarachnoid Hemorrhage Incidence among Whites, Blacks and Caribbean Hispanics: The Northern Manhattan Study. Neuroepidemiology, 26, 147-150. ttps://doi.org/10.1159/000091655
[7]
Mayberg, M.R., Batjer, H.H., Dacey, R., et al. (1994) Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage. A Statement for Healthcare Professionals from a Special Writing Group of the Stroke Council, American Heart Association. Stroke, 25, 2315-2328. https://doi.org/10.1161/01.STR.25.11.2315
[8]
Molyneux, A.J., Kerr, R.S., Yu, L.M., et al. (2005) International Subarachnoid Aneurysm Trial (ISAT) of Neurosurgical Clipping versus Endovascular Coiling in 2143 Patients with Ruptured Intracranial Aneurysms: A Randomized Comparison of Effects on Survival, Dependency, Seizures, Rebleeding, Subgroups, and Aneurysm Occlusion. Lancet, 366, 809-817. https://doi.org/10.1016/S0140-6736(05)67214-5
