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P093/274  Hybrid management of complex vascular pathology
  1. Sevak Badalyan,
  2. Ruben Fanarjyan,
  3. Marta Kalashyan,
  4. Hayk Harutyunyan
  1. Yerevan State Medical University, Neurological Surgery, Yerevan, Armenia


Introduction Currently treatment of cerebral vascular pathology has a huge arsenal due to the expansion of microsurgical and endovascular techniques having different advantages and restraints.

Aim of Study Aim of this study was to analyze the effectiveness and safety of the hybrid approach in the management of cerebral vascular pathology.

Methods We performed retrospective analysis of records of 21 patients, who underwent microsurgical and endovascular management of complex cerebral vascular pathology. The treatment strategy was discussed by dual trained neurosurgical team. The initial Hunt&Hess scale, complications, postoperative 3-month MRS were analyzed.

Results Among 21 patients, 6 presented with subarachnoid hemorrhage complicated with intracerebral hematoma. These patients underwent emergent coil embolization of the aneurysm, followed by decompressive craniectomy with evacuation of hematoma. Two patients among them underwent clipping of regrown aneurysm after three months follow-up. 9 patients had ruptured aneurysms coiled at admission, who further underwent clip ligation of the same aneurysm because of regrowth of previously coiled aneurysm. Four patients had multiple aneurysms, ruptured one was coiled at admission, unruptured aneurysm was clipped electively after initial hospitalization. One patient with arteriovenous malformation initially underwent onyx-embolization of the malformation, which was later completely resected. One patient with polycystic kidney disease underwent staged coiling and clipping of multiple intracranial aneurysms. Neither intraoperative nor postoperative mortality and complication was observed in our series. Mean Hunt&Hess score was 2.4. All patients were independent at 3-month follow up (MRS≤2).

Conclusion Hybrid approach is safe and effective method in management of vascular pathology.

Disclosure of Interest Nothing to disclose

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