Current Status of Ruptured Cerebral Aneurysm Treatment in Regional Hospitals and Results of Coil Embolization

• Nakatsuka Yoshinari

  Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan

• Terashima Mio

  Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan

• Nishikawa Hirofumi

  Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan

• Kawakita Fumihiro

  Department of Neurosurgery, Saiseikai Matsusaka General Hospital, Matsusaka, Mie, Japan

• Fujimoto Masashi

  Department of Neurosurgery, Saiseikai Matsusaka General Hospital, Matsusaka, Mie, Japan

• Shiba Masato

  Department of Innovative Neuro-Intervention Radiology, Mie University Graduate School of Medicine, Tsu, Mie, Japan Center for Vessels and Heart, Mie University Hospital, Tsu, Mie, Japan

• Yasuda Ryuta

  Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan

• Toma Naoki

  Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan

• Sakaida Hiroshi

  Department of Innovative Neuro-Intervention Radiology, Mie University Graduate School of Medicine, Tsu, Mie, Japan Center for Vessels and Heart, Mie University Hospital, Tsu, Mie, Japan

• Suzuki Hidenori

  Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan

• pSEED group

  Members along with their affiliations are listed in appendix

抄録

Objective: We examined the current status of ruptured cerebral aneurysm treatment and results of coil embolization in a district. Methods: We conducted a prospective, multicenter, cooperative observational study involving 169 patients with ruptured cerebral aneurysms who were treated in the acute phase between September 2013 and March 2016. Predictive factors for poor outcome (90-day modified Rankin Scale 3–6) were investigated, and the results were compared between craniotomy and coil embolization. Results: Coil embolization was performed for 39 patients (23.1%). In all, 63 (37.3%) patients had poor outcome. Univariate analysis showed that predictive factors for poor outcome included an advanced age, pre-onset disability, history of cerebral infarction, poor grade on admission, modified Fisher grade 4, acute hydrocephalus, cerebrospinal fluid drainage, craniotomy, craniotomy-related complications, the absence of fasudil hydrochloride administration, delayed cerebral ischemia, delayed cerebral infarction, shunting, pneumonia, and heart failure. On multivariate analysis, predictive factors for poor outcome included pre-onset disability, poor grade on admission, modified Fisher grade 4, delayed cerebral infarction, and heart failure, whereas the prophylactic administration of intravenous fasudil hydrochloride and coil embolization were independent factors associated with good outcome. In patients who underwent craniotomy, the incidences of cerebral vasospasm and cerebral infarction were significantly higher than in those who underwent coil embolization. Conclusion: This was an observational study, and the indication of treatment or strategies differed among institutions, which was a limitation. However, coil embolization was an independent factor associated with good outcome.

収録刊行物

• 脳神経血管内治療

  脳神経血管内治療 12 (3), 109-116, 2018

  特定非営利活動法人 日本脳神経血管内治療学会

キーワード

• subarachnoid hemorrhage
• outcome
• prognostic factor
• endovascular therapy

詳細情報

• CRID: 1390001205301388160
• NII論文ID: 130006516202
• NII書誌ID: AA1229439X
• DOI: 10.5797/jnet.oa.2017-0060
• ISSN: 21862494
• ISSN: 18824072
• NDL書誌ID: 028893530
• Web Site: https://ndlsearch.ndl.go.jp/books/R000000004-I028893530
• Web Site: https://www.jstage.jst.go.jp/article/jnet/12/3/12_oa.2017-0060/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2019185538
• 本文言語コード: en
• データソース種別:
  • JaLC
  • NDL
  • Crossref
  • CiNii Articles
  • KAKEN
• 抄録ライセンスフラグ: 使用不可