scholarly journals Assessment of surgery for ruptured aneurysm in subacute stage. With particular regard to symptomatic vasospasm.

Nosotchu ◽  
1991 ◽  
Vol 13 (5) ◽  
pp. 367-372
Author(s):  
Shinri Oda ◽  
Masami Shimoda ◽  
Osamu Sato ◽  
Ryuichi Tsugane
Keyword(s):  
Ruptured Aneurysm ◽  
Subacute Stage ◽  
Symptomatic Vasospasm

scholarly journals Intraaneurysmal GDC Embolization for Ruptured Aneurysm in the Acute Stage

2000 ◽  
Vol 6 (1_suppl) ◽  
pp. 75-78
Author(s):  
M. Ezura ◽  
A. Takahashi ◽  
T. Yoshimoto
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Clinical Outcome ◽  
Systemic Disease ◽  
Cerebral Aneurysms ◽  
Acute Stage ◽  
Ruptured Aneurysm ◽  
Poor Grade ◽  
Symptomatic Vasospasm ◽  
Tissue Plasminogen ◽  
High Age

This report focused on our treatment protcol and results on the intraaneurysmal GDC embolization for ruptured aneurysm in the acute stage. Clinical materials of this study consist of 39 patients who were treated with intraaneurysmal GDC embolization within 72 hours after the onset of subarachnoid hemorrhage from March 1997 to May 1999. Patients with cerebral aneurysms are always examined as a possible candidate for neurosurgical clipping. If the patient had any difficulties and/or problems on neurosurgical clipping (high age 24, poor grade 12, surgically difficult location 11, systemic disease 2), the patient was treated by intraaneurysmal GDC embolization. GDCs were inserted as tight as possible. Then, spinal drainage was set in patients with thick subarachnoid hemorrhage. Tissue plasminogen activator was administered via the drainage in patients with thicker subarachnoid hemorrhage. Two patients experienced rerupture during peritherapeutic period. Symptomatic vasospasm was observed in 2 patients (5.1%). Good outcome was obtained in 31 out of 34 surviving patients. Symptomatic complication caused by distal embolism occurred in 1 patient, parent artey occlusion in 3 patients. In conclusion, intraaneurysmal GDC embolization is thought to be sufficient regarding prevention of rerup tu re, incidence of vasospasm, and clinical outcome.

The relationship between ruptured aneurysm location, subarachnoid hemorrhage clot thickness, and incidence of radiographic or symptomatic vasospasm in patients enrolled in a prospective randomized controlled trial

2014 ◽  
Vol 120 (2) ◽  
pp. 391-397 ◽  
Author(s):  
Adib A. Abla ◽  
David A. Wilson ◽  
Richard W. Williamson ◽  
Peter Nakaji ◽  
Cameron G. McDougall ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Subarachnoid Hemorrhage ◽  
Controlled Trial ◽  
Delayed Cerebral Ischemia ◽  
Ruptured Aneurysm ◽  
Randomized Controlled ◽  
Symptomatic Vasospasm ◽  
Prospective Randomized Controlled Trial ◽  
Clot Burden ◽  
Middle Cerebral Artery Aneurysms

Object Cerebral vasospasm following subarachnoid hemorrhage (SAH) causes significant morbidity in a delayed fashion. The authors recently published a new scale that grades the maximum thickness of SAH on axial CT and is predictive of vasospasm incidence. In this study, the authors further investigate whether different aneurysm locations result in different SAH clot burdens and whether any concurrent differences in ruptured aneurysm location and maximum SAH clot burden affect vasospasm incidence. Methods Two hundred fifty patients who were part of a prospective randomized controlled trial were reviewed. Most outcome and demographic variables were included as part of the prospective randomized controlled trial. Additional variables were also collected at a later time, including vasospasm data and maximum clot thickness. Results Aneurysms were categorized into 1 of 6 groups: intradural internal carotid artery aneurysms, vertebral artery (VA) aneurysms (including the posterior inferior cerebellar artery), basilar trunk or basilar apex aneurysms, middle cerebral artery aneurysms, pericallosal aneurysms, and anterior communicating artery aneurysms. Twenty-nine patients with nonaneurysmal SAH were excluded. Patients with pericallosal aneurysms had the least average maximum clot burden (5.3 mm), compared with 6.4 mm for the group overall, but had the highest rate of symptomatic vasospasm (56% vs 22% overall, OR 4.9, RR 2.7, p = 0.026). Symptomatic vasospasm occurrence was tallied in patients with clinical deterioration attributable to delayed cerebral ischemia. There were no significant differences in maximum clot thickness between aneurysm sites. Middle cerebral artery aneurysms resulted in the thickest mean maximum clot (7.1 mm) but rates of symptomatic and radiographic vasospasm in this group were statistically no different compared with the overall group. Vertebral artery aneurysms had the worst 1-year modified Rankin scale (mRS) scores (3.0 vs 1.9 overall, respectively; p = 0.0249). A 1-year mRS score of 0–2 (good outcome) was found in 72% of patients overall, but in only 50% of those with pericallosal and VA aneurysms, and in 56% of those with basilar artery aneurysms (p = 0.0044). Patients with stroke from vasospasm had higher mean clot thickness (9.71 vs 6.15 mm, p = 0.004). Conclusions The location of a ruptured aneurysm minimally affects the maximum thickness of the SAH clot but is predictive of symptomatic vasospasm or clinical deterioration from delayed cerebral ischemia in pericallosal aneurysms. The worst 1-year mRS outcomes in this cohort of patients were noted in those with posterior circulation aneurysms or pericallosal artery aneurysms. Patients experiencing stroke had higher mean clot burden.

Angioplasty and coiling of ruptured aneurysm with symptomatic vasospasm: technical case report

2003 ◽  
Vol 59 (5) ◽  
pp. 413-417 ◽  
Author(s):  
Kenji Sugiu ◽  
Atsushi Katsumata ◽  
Yasuhiro Ono ◽  
Takashi Tamiya ◽  
Takashi Ohmoto
Keyword(s):  
Case Report ◽  
Ruptured Aneurysm ◽  
Symptomatic Vasospasm

Intra-aneurysmal GDC Embolization for Ruptured Aneurysm in the Acute Stage

1999 ◽  
Vol 5 (1_suppl) ◽  
pp. 183-186
Author(s):  
M. Ezura ◽  
A. Takahashi ◽  
T. Yoshimoto
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Clinical Outcome ◽  
Systemic Disease ◽  
Cerebral Aneurysms ◽  
Acute Stage ◽  
Ruptured Aneurysm ◽  
Poor Grade ◽  
Symptomatic Vasospasm ◽  
Tissue Plasminogen ◽  
High Age

This study focused on our experiences in intra-aneurysmal embolization for ruptured aneurysm in the acute stage. Clinical materials of this study consist of 37 patients who were treated with intra-aneurysmal GDC embolization within 72 hours after the onset of subarachnoid hemorrhage from December 1995 to July 1998. Patients with cerebral aneurysms are always examined as possible candidates for neurosurgical clipping. If the patient had any difficulties and/or problems on neurosurgical clipping (high age 22, poor grade 15, surgically difficult location 9, systemic disease 3), the patient was treated by intra-aneurysmal GDC embolization. GDCs were inserted as tight as possible. Then, spinal drainage was set in patients with thick subarachnoid hemorrhage. Tissue plasminogen activator was administered via the drainage in patients with thicker subarachnoid hemorrhage. One patient experienced rerupture during peritherapeutic period. Symptomatic vasospasm was observed in three patients (8.1%). Good outcome was obtained in 26 out of 30 surviving patients. Symptomatic complication caused by distal embolism occurred in two patients. In conclusion, intra-aneurysmal GDC embolization is thought to be sufficient regarding prevention of rerupture, incidence of vasospasm, and clinical outcome.

scholarly journals Intracranial Surgery and Postoperative Management of Patients with Ruptured Aneurysm in Acute and Subacute Stage

1979 ◽  
Vol 19 (2) ◽  
pp. 173-179 ◽  
Author(s):  
JINICHI SATO ◽  
OSAMU SATO ◽  
HIROSHI KAMITANI ◽  
ITARU KANAZAWA ◽  
TAKASHI KOKUNAI
Keyword(s):  
Postoperative Management ◽  
Ruptured Aneurysm ◽  
Intracranial Surgery ◽  
Subacute Stage

Penetrating atherosclerotic ulcer aneurysm of the innominate artery

VASA ◽  
2009 ◽  
Vol 38 (3) ◽  
pp. 263-266 ◽  
Author(s):  
Yuan ◽  
Tager
Keyword(s):  
Conservative Treatment ◽  
Thoracic Aorta ◽  
Open Surgery ◽  
Innominate Artery ◽  
Ruptured Aneurysm ◽  
Descending Thoracic Aorta ◽  
Penetrating Atherosclerotic Ulcer ◽  
Descending Aorta

Penetrating atherosclerotic ulcer of the aorta is uncommon, and usually develops in the descending thoracic aorta. Rarely this condition involves the branch vessels of the aorta. We report a case of ruptured aneurysm of the innominate artery resulting from penetrating atherosclerotic ulcer. Open surgery was the treatment of choice for the ruptured aneurysm, while conservative treatment was recommended for the associated penetrating atherosclerotic ulcers of the descending aorta.

Ruptured Aneurysm of the Infrarenal Abdominal Aorta: Impact of Age and Postoperative Complications on Mortality

2003 ◽  
Vol 17 (3) ◽  
pp. 277-283 ◽  
Author(s):  
Pierre Alric ◽  
Frédérique Ryckwaert ◽  
Marie-Christine Picot ◽  
Pascal Branchereau ◽  
Pascal Colson ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Abdominal Aorta ◽  
Ruptured Aneurysm ◽  
Infrarenal Abdominal Aorta
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