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AJNR Am J Neuroradiol. 2014 Nov-Dec;35(11):2136-9. doi: 10.3174/ajnr.A4033. Epub 2014 Jul 3.

Risk factors for early hemorrhagic complications after endovascular coiling of ruptured intracranial aneurysms.

Author information

1
From the Department of Neuroendovascular Treatment, Shiroyama Hospital, Osaka, Japan. tsuyoshi@ya2.so-net.ne.jp.
2
From the Department of Neuroendovascular Treatment, Shiroyama Hospital, Osaka, Japan.

Abstract

BACKGROUND AND PURPOSE:

The risk factors of early hemorrhagic complications after endovascular coiling are not well-known. We identified the factors affecting early hemorrhagic complications, defined as any expansion or appearance of hemorrhage shown by head CT in the initial 48 hours after coiling.

MATERIALS AND METHODS:

We retrospectively reviewed a series of 93 patients who underwent coiling for a ruptured saccular aneurysm between 2006 and 2012 at our hospital.

RESULTS:

Five patients showed early hemorrhagic complications, and all involved an expansion of the existing intracerebral hematoma immediately after coiling. The associated risk factors were accompanying intracerebral hemorrhage at onset (P < .001), postoperative antiplatelet therapy (P < .001), and thromboembolic complications (P = .044). In the accompanying intracerebral hemorrhage group, the associated risk factors were postoperative antiplatelet therapy (P = .044) and earlier initiation of coiling (9.8 ± 6.5 versus 28.1 ± 24.0 hours, P = .023). Early hemorrhagic complications were significant risk factors for worse clinical outcome (modified Rankin Scale, 2.02 ± 2.21 versus 4.4 ± 2.30, P = .022). None of the 93 patients showed further hemorrhage after the initial 48 hours after coiling.

CONCLUSIONS:

The accompanying intracerebral hemorrhage at onset, thromboembolic complications, postoperative antiplatelet therapy, and earlier initiation of coiling were the risk factors for early hemorrhagic complications.

PMID:
24994831
DOI:
10.3174/ajnr.A4033
[Indexed for MEDLINE]
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