Comparison of the unruptured intracranial aneurysm treatment score recommendations with clinical treatment results - A series of 322 aneurysms

被引:3
|
作者
Wende, Tim [1 ]
Kasper, Johannes [1 ]
Wilhelmy, Florian [1 ]
Prasse, Gordian [2 ]
Quaeschling, Ulf [2 ]
Haase, Amelie [1 ]
Meixensberger, Juergen [1 ]
Nestler, Ulf [1 ]
机构
[1] Univ Hosp Leipzig, Dept Neurosurg, D-04103 Leipzig, Germany
[2] Univ Hosp Leipzig, Dept Neuroradiol, D-04103 Leipzig, Germany
关键词
Coiling; Clipping; UIATS; Unruptured intracranial aneurysms; RUPTURE; RISK;
D O I
10.1016/j.jocn.2022.01.038
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Intracranial aneurysms occur with a prevalence of 3-5 %. Subarachnoid hemorrhage (SAH) due to aneurysm rupture is a rare but possibly fatal complication, so that occlusion of unruptured intracranial aneurysms (UIA) must be considered. The Unruptured Intracranial Aneurysm Treatment Score (UIATS) offers support for clinical decision making and has been shown to correlate with real life decisions in clinical practice. However, there is no data concerning the correlation of patient outcome and UIATS. Patients presenting to our outpatient clinic between January 1st, 2014 and December 31st, 2017 were retrospectively analyzed. We recorded the Extended Glasgow Outcome Scale (GOS-E) for longest possible follow-up, the choice of treatment, complications and UIATS recommendation. We included 221 patients with 322 UIA. 124 (38.5 %) UIA were observed and 198 (61.5 %) were occluded, of which 62 (31.3 %) underwent open surgery and 136 (68.7 %) were treated endovascularly. Spearman's rank correlation between our treatment choice and conclusive UIATS recommendation was 0.362 (p < 0.001). If UIATS was inconclusive, there were significantly more treatment-associated deteriorations (10/66 versus 7/132, p = 0.020). Otherwise, UIATS was not significantly associated with outcome. Therefore, treatment choice for UIA remains an individual decision. However, inconclusive UIATS must trigger vigilance and may be a negative prognostic marker for complications.
引用
收藏
页码:104 / 108
页数:5
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