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ORIGINAL ARTICLE
Year : 2014  |  Volume : 27  |  Issue : 1  |  Page : 184-190

Safety and efficacy of endovascular treatment of ruptured cerebral aneurysms


1 Department of Neurosurgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt
2 Department of Neurosurgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt
3 Department of Neurosurgery, Faculty of Medicine, Tanta University, Tanta, Egypt
4 Department of General Surgery Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt

Correspondence Address:
Ahmed S. Mansour
Department of Neurosurgery, Menoufia Faculty of Medicine, Yaseen Abdelghaffar Street, Shebin El-Koum
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-2098.132798

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Objectives The aim of this study was to study the safety and efficacy of endovascular treatment of ruptured cerebral aneurysms. Background Endovascular treatment has become a standard method for the treatment of intracranial aneurysms. Materials and methods A total of 12 patients were referred for endovascular treatment of ruptured aneurysms: six women and six men, with a mean age of 48.8 years. Patients were classified according to the Hunt and Hess grading system. There were one grade I patient (8.3%), five grade II (41.6%) patients, and six grade III (50%) patients. No patient belonged to grade IV (0%) or grade V (0%). Clinical follow-up was conducted at 6 months, and the results are classified according to the Glasgow Outcome Scale (GOS). Control angiograms were obtained immediately and at 6 months. Results Immediate angiographic results were satisfactory in seven patients (58.3%; complete obliteration), and five patients experienced some residual symptoms of their aneurysms (41.6%). The mortality and morbidity was low. At 6 months, the outcomes were as follows: GOS score of 1, two patients (16.6%); GOS score of 2, seven patients (58.3%); GOS score of 3, three patients (25%); and GOS score of 4 and 5, zero patients (0%). Six-month angiographic follow-up data were available for 10 patients (83.3%). The morphological results were satisfactory in most patients: complete occlusion in seven patients (58.3%) and residual or incomplete occlusion in three patients (25%); two patients (16.6%) underwent recoiling. Conclusion Endovascular treatment of ruptured aneurysms was attempted without clinically significant complications in 91.6% of patients. Morphological results were unsatisfactory in 16.6% of patients. Complete obliteration of the sac, with or without residual neck, is essential to prevent subsequent bleeding, which occurred in 66.6% of patients. The overall outcome at 6 months was satisfactory, despite a selected group of patients [three patients (25%)] having residual complications or residual aneurysms.


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