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67th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Korean Neurosurgical Society (KNS)

German Society of Neurosurgery (DGNC)

12 - 15 June 2016, Frankfurt am Main

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Risk of periprocedural hemorrhage in surgical and endovascular treatment of ruptured cerebral aneurysms

Meeting Abstract

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  • Walid Albanna - Klinik für Neurochirurgie, RWTH Aachen, Germany
  • Louisa Merkelbach - Klinik für Neurochirurgie, RWTH Aachen, Germany
  • Gerrit Schubert - Klinik für Neurochirurgie, RWTH Aachen, Germany
  • Martin Wiesmann - Institut für Diagnostische und Interventionelle Neuroradiologie, RWTH Aachen, Germany
  • Hans Clusmann - Klinik für Neurochirurgie, RWTH Aachen, Germany
  • Georg Neuloh - Klinik für Neurochirurgie, RWTH Aachen, Germany

Deutsche Gesellschaft für Neurochirurgie. 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS). Frankfurt am Main, 12.-15.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocP 089

doi: 10.3205/16dgnc464, urn:nbn:de:0183-16dgnc4645

Published: June 8, 2016

© 2016 Albanna et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: New techniques for aneurysm embolization and endovascular treatment of vasospasm in SAH require antiplatelet treatment in order to prevent thromboembolism. This may be associated with an increased risk for periprocedural hemorrhage (PH). In a retrospective study, we explore the risk of PH in a multifactorial design.

Method: A total of 168 consecutive cases (n=127 female; median age 54 years) with a ruptured intracranial aneurysm treated between 1/2011-6/2015 were reviewed retrospectively. 77 patients had received antiplatelet treatment for the coiling of 80 aneurysms, and vasospasm therapy in 30 cases. In a multifactorial analysis, we looked for conditions associated with increased rates of PH.

Results: PH occurred in 31 cases (18,5%). It was significantly more frequent after coiling as compared with clipping (22 vs. 9 cases, p =0.004). Antiplatelet treatment was the only further predictor for PH (p = 0,023). However, Tirofibane under endovascular vasospasm therapy alone did not increase the rate of PH. Cases with PH were ventilated for a longer period of time (p = 0,001).

Conclusions: PH was significantly more frequent after coiling than after clipping of ruptured cerebral aneurysms. The occurrence of PH depended significantly on antiplatelet treatment. Antiplatelet agents should be considered as a relevant risk factor for periprocedural hemorrhage when planning treatment modalities.