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Neuroradiology

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01-02-2015 | Interventional Neuroradiology

Ultra-early versus delayed coil treatment for ruptured poor-grade aneurysm

Authors: Yong-Chun Luo, Chun-Sen Shen, Jin-Long Mao, Chun-Yang Liang, Qiang Zhang, Zi-Jun He

Published in: Neuroradiology | Issue 2/2015

Abstract

Introduction

The timing of definitive aneurysm treatment (coiling or clipping) in poor-grade (Hunt-Hess IV or V) subarachnoid haemorrhage (SAH) patients has been a controversial topic. The purpose of this retrospective study was to analyse whether ultra-early coiling of ruptured intracranial aneurysms improves the clinical outcomes of poor-grade SAH patients.

Methods

The records of patients with aneurysmal SAH who were treated with endovascular coiling were retrieved. The patients were classified into two groups: group A (patients coiled within 24 h of SAH) and group B (patients coiled ≥ 24 h after SAH). For each group, the patient demographics, Fisher grade, aneurysm characteristics and clinical outcomes were recorded. Outcomes were measured at 6 months using the modified Rankin Scale (mRS).

Results

Thirty-one patients were coiled within 24 h of SAH (group A), and fourteen patients were coiled ≥24 h after SAH (group B). Groups A and B had similar clinical and angiographic characteristics. The clinical outcomes showed that a total of 58.1 % of the patients (18 of 31) in group A were independent (mRS 0–2) compared with 21.4 % of the patients (3 of 14) in group B (P = .028). Univariate analysis demonstrated that ultra-early coiling (P = .028) proved to be an independent predictor of better clinical outcomes (mRS 0–2).

Conclusions

Ultra-early (<24 h after SAH) coiling of ruptured aneurysms was associated with improved clinical outcomes compared to coiling at ≥24 h in poor-grade SAH patients. Larger, prospective studies are required to adequately assess the outcome differences between these two groups.

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Title: Ultra-early versus delayed coil treatment for ruptured poor-grade aneurysm
Authors: Yong-Chun Luo
Chun-Sen Shen
Jin-Long Mao
Chun-Yang Liang
Qiang Zhang
Zi-Jun He
Publication date: 01-02-2015
Publisher: Springer Berlin Heidelberg
Published in: Neuroradiology / Issue 2/2015
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-014-1454-8

At a glance: The STEP trials

Springer Medicine

Ultra-early versus delayed coil treatment for ruptured poor-grade aneurysm

Abstract

Introduction

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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