Artikel
Quality of life after treatment of unruptured intracranial aneurysms when endovascular therapy is the preferred therapy – a retrospective single-center analysis
Lebensqualität nach interdisziplinärer Behandlung nichtrupturierter intrakranieller Aneurysmen, wenn die endovaskuläre Therapie die Therapie erster Wahl ist – eine retrospektive Analyse eines Zentrums
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Autoren
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M. Ortler
- Universitätsklinik für Neurochirurgie, Medizinische Universität Innsbruck, Österreich
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M. Matt
- Universitätsklinik für Neurochirurgie, Medizinische Universität Innsbruck, Österreich
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A. Chemelli
- Universitätsklinik für Radiologie I , Medizinische Universität Innsbruck, Österreich
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P. Waldenberger
- Universitätsklinik für Radiologie I , Medizinische Universität Innsbruck, Österreich
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E. Schmutzhard
- Universitätsklinik für Neurologie, Medizinische Universität Innsbruck, Österreich
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K. Twerdy
- Universitätsklinik für Neurochirurgie, Medizinische Universität Innsbruck, Österreich
| Veröffentlicht: | 30. Mai 2008 |
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Gliederung
Text
Objective: Treatment indications and the optimal treatment modality for unruptured intracranial aneurysms (UIAs) remain controversial. We investigated outcome of UIAs after treatment when endovascular therapy is the treatment modality of choice.
Methods: N=128 patients harbouring n=195 unruptured intracranial aneurysms were treated between January 2001 and December 2006. After 2003, the indication for treatment followed the guidelines published by the Deutsche Gesellschaft für Neurochirurgie (Raabe 2003). All patients were discussed in an interdisciplinary forum. Endovascular therapy was the preferred treatment method whenever feasible. Only patients, in whom the quality of life-evaluation was not obfuscated by a concomitant subarachnoid hemorrhage were included in the study, leaving a study population of n=125 patients. Quality of life was classified using the modified Rankin scale (mRS) prior to the intervention, on postoperative day 10 and six months after the intervention.
Results: The number of treated UIAs n=155. Endovascular therapy was used in n=106 (68,4%) and open surgery in n=49 (31,6%) cases. Obliteration was complete in n=37 (86%) of the surgical and n=70 (72,2%) of the endovascular cases. At the six-month follow-up, QOL as measured by mRS was identical to that prior to the intervention in 101 cases (81,5%, in n=32 (82,1%) after open surgery and n=69 (81,2%) after endovascular treatment. In 19 cases (15,3%), the QOL at six months was worse than prior to intervention: n= 5 surgical (12,8%) patients and n=14 (16,5%) endovascular patients. A decrease by >1 point of the mRS was observed in 2 surgical (5.1%) and n=8 (9.4%) endovascular patients.
Conclusions: With regard to quality of life, open surgery and endovascular therapy offer comparable results in the treatment of UIAs. QOL had decreased in a remarkable number of patients (15%). This decrease was more accentuated in the endovascular group.
