Objective The purpose of this study was to report the authors’ experiences in stenting for ruptured cerebral aneurysms in the acute period and to evaluate the hemorrhagic and ischemic complications and risk factors.
Methods Between January 2013 and October 2018, fifty-four patients had stenting with or without coiling for treatment of acutely ruptured cerebral aneurysms that were not amendable to coiling alone. Hospital notes were retrospectively reviewed. All patients had a dose of intravenous abciximab 10 mg and heparin 2000 unit before stenting and dual antiplatelet loading and daily treatment started after procedure.
Results Of the 54 patients, twenty-nine (54%) had braided stents, nine (17%) had laser-cut stents, and 16(30%) had flow diverters. Thirty-seven (69%) had also coiling and 17(31%) had stenting alone. There was 2(4%) rebleed in two patients with braided stent and partial embolization resulting in mortality. There were three (6%) procedure-related cerebral infarction. There were 3(6%) significant intraventricular hemorrhage and intracerebral hemorrhage.
Conclusions In patients undergoing stenting for acutely ruptured cerebral aneurysms, partial embolization and ICP catheter insertion were risk factors for complications and mortality. Procedure-related infarction rate was 6%. Stenting could be considered as an alternative treatment strategy for acutely ruptured cerebral aneurysms not amendable to coiling alone.
Disclosures G. Wong: 1; C; Medtronic.
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