Analysis of short-term efficacy and rebleeding risk in aneurysmal subarachnoid hemorrhage patients undergoing vascular intervention.

Abstract

Objective: To evaluate the short-term efficacy and rebleeding risk of vascular intervention in patients with aneurysmal subarachnoid hemorrhage (aSAH).

Methods: This retrospective study included 98 aSAH patients treated between August 2020 and May 2023. Based on the treatment method, patients were divided into an interventional group (n = 50, treated with endovascular embolization) and a craniotomy group (n = 48, treated with microsurgical clipping). Surgical parameters, clinical outcomes, immune markers, prognosis scores, cognitive function, and safety were compared using t-tests or chi-square tests. Binary logistic regression identified independent risk factors for clinical outcomes and rebleeding.

Results: The interventional group showed significantly less intraoperative blood loss, shorter hospital stays, and shorter operative times compared to the craniotomy group (all P < 0.05). Clinical outcomes and Glasgow Outcome Scale scores were better in the interventional group (all P < 0.05). At 3 days and 3 months post-surgery, immune markers (IgG, IgA, IgM) were significantly higher in the interventional group (all P < 0.05). Additionally, MMSE scores at 3 days post-surgery were higher, and the incidence of postoperative cognitive dysfunction within 3 months was lower (both P < 0.05). The complication rate was significantly lower in the interventional group (12.00% vs. 37.50%, P < 0.05). Preoperative Hunt-Hess grade, surgical approach, age, and postoperative complications were identified as independent risk factors for prognosis (all P < 0.05), while surgical approach, age, and Hunt-Hess grade were risk factors for rebleeding (all P < 0.05).

Conclusion: Vascular intervention provides superior short-term efficacy in aSAH patients, with faster recovery, reduced surgical trauma, and better clinical outcomes compared to craniotomy. Monitoring should be intensified for older patients and those with higher preoperative Hunt-Hess grades to minimize the risks of poor prognosis and rebleeding.