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      Risk Factors for Early Hemorrhagic Complications after Endovascular Coiling of Ruptured Intracranial Aneurysms

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          Abstract

          A review of 93 patients treated with coiling for ruptured aneurysms was done to identify risk factors of early hemorrhagic complications. Risk factors identified included intracerebral hematoma at presentation, procedural thromboembolic complications, postcoiling antiplatelet therapy, and early initiation of coiling.

          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.

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          Author and article information

          Journal
          AJNR Am J Neuroradiol
          AJNR Am J Neuroradiol
          ajnr
          ajnr
          AJNR
          AJNR: American Journal of Neuroradiology
          American Society of Neuroradiology
          0195-6108
          1936-959X
          November 2014
          : 35
          : 11
          : 2136-2139
          Affiliations
          [1] aFrom the Department of Neuroendovascular Treatment, Shiroyama Hospital, Osaka, Japan.
          Author notes
          Please address correspondence to Tsuyoshi Ohta, MD, Department of Neuroendovascular Treatment, Shiroyama Hospital, 2-8-1 Habikino, Habikino City, Osaka 583-0872, Japan; e-mail: tsuyoshi@ 123456ya2.so-net.ne.jp
          Article
          PMC7965193 PMC7965193 7965193 14-00234
          10.3174/ajnr.A4033
          7965193
          24994831
          a33dba28-00a7-42e4-9cef-f88f1bdce75b
          © 2014 by American Journal of Neuroradiology
          History
          : 9 March 2014
          : 19 May 2014
          Categories
          Interventional
          Fellows' Journal Club

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