Comparison of Symptomatic Vasospasm after Surgical Clipping and Endovascular Coiling
Vasospasm, initial neurological damage, rebleeding, and periprocedural complications are associated prognostic factors for clinical outcomes after aneurysmal subarachnoid hemorrhage (SAH). In this study, factors related to delayed ischemic neurological deficit (DIND) are evaluated using data from ou...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
The Japan Neurosurgical Society
2022-05-01
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| Series: | Neurologia Medico-Chirurgica |
| Subjects: | |
| Online Access: | https://www.jstage.jst.go.jp/article/nmc/62/5/62_2021-0126/_pdf/-char/en |
| _version_ | 1828213316324950016 |
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| author | Hirotoshi IMAMURA Shoichi TANI Hidemitsu ADACHI Ryu FUKUMITSU Tadashi SUNOHARA Nobuyuki FUKUI Yoshihiro OMURA Natsuhi SASAKI Tomoaki AKIYAMA Tatsumaru FUKUDA Shinji KAJIURA Masashi SHIGEYASU Kento ASAKURA Ryo HORII Nobuyuki SAKAI |
| author_facet | Hirotoshi IMAMURA Shoichi TANI Hidemitsu ADACHI Ryu FUKUMITSU Tadashi SUNOHARA Nobuyuki FUKUI Yoshihiro OMURA Natsuhi SASAKI Tomoaki AKIYAMA Tatsumaru FUKUDA Shinji KAJIURA Masashi SHIGEYASU Kento ASAKURA Ryo HORII Nobuyuki SAKAI |
| author_sort | Hirotoshi IMAMURA |
| collection | DOAJ |
| description | Vasospasm, initial neurological damage, rebleeding, and periprocedural complications are associated prognostic factors for clinical outcomes after aneurysmal subarachnoid hemorrhage (SAH). In this study, factors related to delayed ischemic neurological deficit (DIND) are evaluated using data from our institute for the last 18 years. Data from 2001 to 2018 of patients with aneurysmal SAH who underwent surgical clipping (SC) or endovascular coiling (EC) within 7 days of onset were retrospectively analyzed. Cases of mortality within 5 days after treatment were excluded. Multivariate analysis was used to identify the risk factors for DIND. In total, 840 cases of SAH were assessed; among these cases, 384 (45.7%) and 456 (54.3%) were treated with SC and EC, respectively. The frequency of DIND in the EC group was significantly less than that in the SC group (11.8% vs. 17.7%; p = 0.016). In the results of multivariate analysis, internal carotid artery (ICA) aneurysm and hemorrhagic complications were the risk factors for DIND. Cilostazol administration and EC were significant factors for vasospasm prevention after aneurysmal SAH (odds ratio of ICA aneurysm: 1.59, hemorrhagic complications: 1.76, SC: 1.51, and cilostazol administration: 0.51, respectively). Cilostazol administration was also a significant factor in patients who were treated with EC. ICA aneurysm, treatment strategy, hemorrhagic complications, and cilostazol administration were associated with DIND. Oral administration of cilostazol and avoiding hemorrhagic complications were effective in DIND prevention. If both treatments are available for ruptured aneurysms, clinicians should choose EC on the basis of its ability to prevent DIND. |
| first_indexed | 2024-04-12T14:48:20Z |
| format | Article |
| id | doaj.art-d174591ddb0c432291d3dfad023ecf47 |
| institution | Directory Open Access Journal |
| issn | 1349-8029 |
| language | English |
| last_indexed | 2024-04-12T14:48:20Z |
| publishDate | 2022-05-01 |
| publisher | The Japan Neurosurgical Society |
| record_format | Article |
| series | Neurologia Medico-Chirurgica |
| spelling | doaj.art-d174591ddb0c432291d3dfad023ecf472022-12-22T03:28:35ZengThe Japan Neurosurgical SocietyNeurologia Medico-Chirurgica1349-80292022-05-0162522323010.2176/jns-nmc.2021-01262021-0126Comparison of Symptomatic Vasospasm after Surgical Clipping and Endovascular CoilingHirotoshi IMAMURA0Shoichi TANI1Hidemitsu ADACHI2Ryu FUKUMITSU3Tadashi SUNOHARA4Nobuyuki FUKUI5Yoshihiro OMURA6Natsuhi SASAKI7Tomoaki AKIYAMA8Tatsumaru FUKUDA9Shinji KAJIURA10Masashi SHIGEYASU11Kento ASAKURA12Ryo HORII13Nobuyuki SAKAI14Department of Neurosurgery, Kobe City Medical Center General HospitalDepartment of Neurosurgery, Kobe City Medical Center General HospitalDepartment of Neurosurgery, Kobe City Medical Center General HospitalDepartment of Neurosurgery, Kobe City Medical Center General HospitalDepartment of Neurosurgery, Kobe City Medical Center General HospitalDepartment of Neurosurgery, Kobe City Medical Center General HospitalDepartment of Neurosurgery, Kobe City Medical Center General HospitalDepartment of Neurosurgery, Kobe City Medical Center General HospitalDepartment of Neurosurgery, Kobe City Medical Center General HospitalDepartment of Neurosurgery, Kobe City Medical Center General HospitalDepartment of Neurosurgery, Kobe City Medical Center General HospitalDepartment of Neurosurgery, Kobe City Medical Center General HospitalDepartment of Neurosurgery, Kobe City Medical Center General HospitalDepartment of Neurosurgery, Kobe City Medical Center General HospitalDepartment of Neurosurgery, Kobe City Medical Center General HospitalVasospasm, initial neurological damage, rebleeding, and periprocedural complications are associated prognostic factors for clinical outcomes after aneurysmal subarachnoid hemorrhage (SAH). In this study, factors related to delayed ischemic neurological deficit (DIND) are evaluated using data from our institute for the last 18 years. Data from 2001 to 2018 of patients with aneurysmal SAH who underwent surgical clipping (SC) or endovascular coiling (EC) within 7 days of onset were retrospectively analyzed. Cases of mortality within 5 days after treatment were excluded. Multivariate analysis was used to identify the risk factors for DIND. In total, 840 cases of SAH were assessed; among these cases, 384 (45.7%) and 456 (54.3%) were treated with SC and EC, respectively. The frequency of DIND in the EC group was significantly less than that in the SC group (11.8% vs. 17.7%; p = 0.016). In the results of multivariate analysis, internal carotid artery (ICA) aneurysm and hemorrhagic complications were the risk factors for DIND. Cilostazol administration and EC were significant factors for vasospasm prevention after aneurysmal SAH (odds ratio of ICA aneurysm: 1.59, hemorrhagic complications: 1.76, SC: 1.51, and cilostazol administration: 0.51, respectively). Cilostazol administration was also a significant factor in patients who were treated with EC. ICA aneurysm, treatment strategy, hemorrhagic complications, and cilostazol administration were associated with DIND. Oral administration of cilostazol and avoiding hemorrhagic complications were effective in DIND prevention. If both treatments are available for ruptured aneurysms, clinicians should choose EC on the basis of its ability to prevent DIND.https://www.jstage.jst.go.jp/article/nmc/62/5/62_2021-0126/_pdf/-char/envasospasmsurgical clippingendovascular coilingcilostazol |
| spellingShingle | Hirotoshi IMAMURA Shoichi TANI Hidemitsu ADACHI Ryu FUKUMITSU Tadashi SUNOHARA Nobuyuki FUKUI Yoshihiro OMURA Natsuhi SASAKI Tomoaki AKIYAMA Tatsumaru FUKUDA Shinji KAJIURA Masashi SHIGEYASU Kento ASAKURA Ryo HORII Nobuyuki SAKAI Comparison of Symptomatic Vasospasm after Surgical Clipping and Endovascular Coiling Neurologia Medico-Chirurgica vasospasm surgical clipping endovascular coiling cilostazol |
| title | Comparison of Symptomatic Vasospasm after Surgical Clipping and Endovascular Coiling |
| title_full | Comparison of Symptomatic Vasospasm after Surgical Clipping and Endovascular Coiling |
| title_fullStr | Comparison of Symptomatic Vasospasm after Surgical Clipping and Endovascular Coiling |
| title_full_unstemmed | Comparison of Symptomatic Vasospasm after Surgical Clipping and Endovascular Coiling |
| title_short | Comparison of Symptomatic Vasospasm after Surgical Clipping and Endovascular Coiling |
| title_sort | comparison of symptomatic vasospasm after surgical clipping and endovascular coiling |
| topic | vasospasm surgical clipping endovascular coiling cilostazol |
| url | https://www.jstage.jst.go.jp/article/nmc/62/5/62_2021-0126/_pdf/-char/en |
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