-
Views
-
Cite
Cite
Mamdouh Shaaban Saleh, El-Hussam El-Hussiney, Mohammed Alaa Aldien Habib, Ahmed Faisal Tobar, Ahmed El-Sayed, Safety and Efficacy in Treatment of Ruptured Small Anterior Circulation Aneurysms, QJM: An International Journal of Medicine, Volume 117, Issue Supplement_2, October 2024, hcae175.566, https://doi.org/10.1093/qjmed/hcae175.566
Close - Share Icon Share
Abstract
Small aneurysms ≤10 mm in diameter account for almost 6% of all ruptured intracranial aneurysms and pose a therapeutic dilemma for the treating physician. Published studies have investigated the safety and efficacy of endovascular therapy unilaterally without comparison to a surgical group, which limits the value of their findings
To review of literature and recent publications regarding treatment of the small anterior circulation aneurysms, evaluate the outcome of treatment of small anterior circulation aneurysms in Ain Shams University Hospitals, determine the incidence of various complications, define the good and bad prognostic criteria for outcome and to compare between the variable modalities of treatment of anterior circulation aneurysms
This prospective study was done in the Neurosurgery Department in Ain Shams University hospital, on 30 patients admitted to the Emergency Unit of Neurosurgery suffering from spontaneous subarachnoid hemorrhage (SAH) due to ruptured small anterior circulation aneurysm.
There was no statistically significant difference found between clipping group and coiling group regarding age, sex, aneurismal size, Hunt & Hess grade and Fisher grading. Also, there was no statistically significant difference found between clipping group and coiling group regarding percentage of complications during procedure. There was no statistically significant difference found between clipping group and coiling group regarding percentage of complications post procedure except pneumocephalus was found with higher percentage in clipping group (33.3%) than coiling group (0.0%) with p-value = 0.014. There was no statistically significant difference found between clipping group and coiling group regarding modified Rankin Scale with p-value = 0.440
Lower procedural complication rates were seen with endovascular therapy as compared to open surgery in small ruptured aneurysm. Overall patient outcomes, however, were similar in both groups. In light of our results, endovascular treatment of small ruptured aneurysm seems to be feasible, safe, and effective and might be a preferred option in this setting. These data provide impetus for further study, in which small ruptured aneurysm need not be excluded from comparisons of coiling and neurosurgical clipping. More specifically, the stage is set for a randomized controlled trial to compare the 2 treatment modalities in patients with small ruptured aneurysm.
