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Adverse events during endovascular treatment of ruptured aneurysms: a prospective nationwide study on subarachnoid hemorrhage in sweden
Department of Clinical Sciences, Neurosurgery, Lund University, Lund, Sweden.
Department of Clinical Neuroscience, University of Gothenburg, Gothenburg, Sweden.
Department of Clinical Sciences, Linköping University, Linköping, Sweden.
Department of Neuroscience, Section of Neurosurgery, Uppsala University, Uppsala, Sweden.
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2023 (Engelska)Ingår i: Brain and Spine, ISSN 2772-5294, Vol. 3, artikel-id 102708Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Introduction: A range of adverse events (AEs) may occur in patients with subarachnoid hemorrhage (SAH). Endovascular treatment is commonly used to prevent aneurysm re-rupture.

Research question: The aim of this study was to identify AEs related to endovascular treatment, analyze risk factors for AEs and how AEs affect patient outcome.

Material and methods: Patients with aneurysmal SAH admitted to all neurosurgical centers in Sweden during a 3.5-year period (2014–2018) were prospectively registered. AEs related to endovascular aneurysm treatment were thromboembolic events, aneurysm re-rupture, vessel dissection and puncture site hematoma. Potential risk factors for the AEs were analyzed using multivariate logistic regression. Functional outcome was assessed at one year using the extended Glasgow outcome scale.

Results: In total, 1037 patients were treated for ruptured aneurysms. Of which, 715 patients were treated with endovascular occlusion. There were 115 AEs reported in 113 patients (16%). Thromboembolic events were noted in 78 patients (11%). Aneurysm re-rupture occurred in 28 (4%), vessel dissection in 4 (0.6%) and puncture site hematoma in 5 (0.7%). Blister type aneurysm, aneurysm smaller than 5 mm and endovascular techniques other than coiling were risk factors for treatment-related AEs. At follow-up, 230 (32%) of the patients had unfavorable outcome. Patients suffering intraprocedural aneurysm re-rupture were more likely to have unfavorable outcome (OR 6.9, 95% CI 2.3–20.9).

Discussion and conclusion: Adverse events related to endovascular occlusion of a ruptured aneurysm were seen in 16% of patients. Aneurysm re-rupture during endovascular treatment was associated with increased risk of unfavorable functional outcome.

Ort, förlag, år, upplaga, sidor
Elsevier, 2023. Vol. 3, artikel-id 102708
Nyckelord [en]
Adverse event, Aneurysm, Complication, Endovascular, Outcome, Subarachnoid hemorrhage
Nationell ämneskategori
Neurologi
Identifikatorer
URN: urn:nbn:se:umu:diva-217030DOI: 10.1016/j.bas.2023.102708Scopus ID: 2-s2.0-85176742813OAI: oai:DiVA.org:umu-217030DiVA, id: diva2:1814179
Tillgänglig från: 2023-11-23 Skapad: 2023-11-23 Senast uppdaterad: 2024-04-24Bibliografiskt granskad

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Lindvall, PeterAineskog, Helena

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