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

  • Interventional Neuroradiology
  • Published:
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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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Ethical standards and patient consent

We declare that all human and animal studies have been approved by the Ethics Committee of the Military General Hospital of Beijing PLA and have therefore performed in accordance the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all the patients gave informed consent prior to inclusion in this study.

Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Neurosurgery, The Military General Hospital of Beijing PLA, No. 5, Nanmencang Alley, Dongcheng District, Beijing, 100010, China

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

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  1. Yong-Chun Luo
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  2. Chun-Sen Shen
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  3. Jin-Long Mao
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  4. Chun-Yang Liang
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  6. Zi-Jun He
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Correspondence to Zi-Jun He.

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Luo, YC., Shen, CS., Mao, JL. et al. Ultra-early versus delayed coil treatment for ruptured poor-grade aneurysm. Neuroradiology 57, 205–210 (2015). https://doi.org/10.1007/s00234-014-1454-8

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  • DOI: https://doi.org/10.1007/s00234-014-1454-8

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