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E-218 Stent-assisted coiling of acute ruptured cerebral aneurysms
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  1. V Berestov,
  2. K Orlov,
  3. N Strelnikov,
  4. M Demyanovskaya
  1. Neurosurgery department, National Medical Research Center (Meshalkin Clinic), Novosibirsk, Russian Federation

Abstract

Background Applying of stents for endovascular treatment of cerebral aneurysms in the acute period of intracranial hemorrhage remains a debatable topic at present time. In this work we reflected our experience in treatment of acute aneurysms,

Materials and Methods January 2011 through December 2019, 186 patients with 204 cerebral aneurysms were treated in our department in the acute period of hemorrhage: 27 patients had multiple aneurysms (2 to 5). Patients were 20 to 78 years old (47.2 years mean). Operations were performed in the period from 0 to 19 days after the rupture of the aneurysm.

Results The most frequent localization of aneurysms in our series is the supraclinoid part of the internal carotid artery - 40.2%, ACA aneurysms - 25.8%, bifurcation of the middle cerebral artery - 17.5%; posterior circulation was in 12.4% of cases.Coiling without assistance was used in 44.7% of aneurysms; 33.6% of aneurysms required the use of balloons; 21.5% of aneurysms required stent assistance.Stent implantation in the acute period of subarachnoid hemorrhage was used after transvenous administration of Eptifibatide (Integrilin); after the procedure patients received oral antiplatelet agents.No perioperative complications were reported in our series. General disability is 6.3%, mortality - 2.1%.

Conclusion Coiling with intracranial stents is effective for complex aneurysms with a wide neck in the acute period of intracranial hemorrhage, and it allows achieving a good result without increasing the risk of surgical treatment.

Disclosures V. Berestov: None. K. Orlov: None. N. Strelnikov: None. M. Demyanovskaya: None.

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