Author/Editor     Bunc, Gorazd; Ravnik, Janez; Voršič, Matjaž; Šeruga, Tomaž; Jevšek, Marko; Šmigoc, Tomaž; Velnar, Tomaž
Title     Endovascular versus operative treatment of cerebral aneurysms
Type     članek
Vol. and No.     Letnik 128, št. 9
Publication year     2016
Volume     str. 354-359
ISSN     0043-5325 - Wiener klinische Wochenschrift
Language     eng
Abstract     Background Subarachnoid haemorrhage is a debilitating disease. The treatment options include surgical clipping or endovascular embolisation. Still, many controversies exist about which method is more convenient. Methods In the retrospective study from January 2006 to December 2013, 129 patients with subarachnoid haemorrhage were analysed. They were classified according to the WFNS grade and Fisher scale. The diagnosis of intracranial aneurysms was based on computerised tomographic angiography and digital subtraction angiography. All patients received the standard therapy against vasospasm. The treatment outcome was evaluated with Glasgow Outcome Scale. Results Of 129 patients, surgery was employed in 40, endovascular obliteration in 86 patients and 3 patients received both forms of treatment. Four factors were statistically significant for worse results in the univariate analysis: the age, WFNS grade, Fisher grade and the presence of clinical vasospasm. In the multivariate analysis, only the age, WFNS grade and the presence of clinical vasospasm remained statistically significant for the outcome. There was a trend towards better outcome for the patients that had endovascular treatment compared with patients who were treated surgically, although the difference was not statistically significant. Conclusions Although the endovascular embolisation in relation to the surgical clipping is becoming a more popular treatment method for ruptured cerebral aneurysms it cannot offer reliable endovascular exclusion in all types of aneurysms. Based on our experience, it is therefore necessary to look at these two methods as complementary that may both be used separately or in combination for the well-being of the patient.
Keywords     subarahnoidna krvavitev
cerebralna anevrizma
endovaskularno zdravljenje
izid zdravljenja
nevrokirurgija