A retrospective clinical and angiographic study of the coiling outcome of ruptured intracranial aneurysms

Abstract

Many factors that determine the outcome of endovascular treatment of ruptured intracranial aneurysms are still controversial. We conducted a retrospective study of 203 patients with ruptured aneurysms treated by coiling to assess these factors. The Glasgow Outcome Scale score was used for clinical follow-up and magnetic resonance angiography for angiographic follow-up. Overall outcome and pretreatment variables predicting outcome were thoroughly analyzed. Good clinical grade on presentation was correlated with a better clinical outcome (p<0.001); however, symptomatic vasospasm (15.8% of patients) was correlated with a worse clinical outcome (p<0.001). Six patients (3%) suffered ischemic complications at the time of treatment, hemorrhagic events occurred in five patients (2.5%), permanent morbidity in five patients (2.5%) and overall mortality in 5.4%. In this series, we studied some factors currently debated in the literature and concluded that elderly patients (> or =65 years) with aneurysmal subarachnoid hemorrhage can safely be treated with endovascular therapy with a favorable outcome and that middle cerebral artery aneurysms can be safely embolized with results comparable to other locations.