Vasospasm as a Complication after Aneurysmal Rupture and Its Relation with Surgical Clipping and Endovascular Coiling among a Georgian Sample  

作　　者：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 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(New-Vision University, Tbilisi, Georgia;Medical Corporation Evex, Caucasus Medical Center, Tbilisi, Georgia;New-Vision University Hospital, Tbilisi, Georgia)

机构地区：[1]New-Vision University, Tbilisi, Georgia [2]Medical Corporation Evex, Caucasus Medical Center, Tbilisi, Georgia [3]New-Vision University Hospital, Tbilisi, Georgia

出　　处：《World Journal of Neuroscience》2022年第3期153-162,共10页神经科学国际期刊（英文）

摘　　要：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.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.

关 键 词：ANEURYSMS Subarachnoid Hemorrhage Surgical Clipping Endovascular Coiling VASOSPASM 

分 类 号：R74[医药卫生—神经病学与精神病学]