Vasospasm as a Complication after Aneurysmal Rupture and Its Relation with Surgical Clipping and Endovascular Coiling among a Georgian Sample

M. Kassem, Lama Alchaar, A. Abdelkader, Mohammad Eghbalbakhtiary, Koka Gogichashvili, M. Khinikadze, Shriniwas Yadav, Astha Zambani, Sonali Mankar, Mahalakshmi Jayasankar, Mohamed Abdelsattar Atta Ismail Ali, Sarah Ibrahim, N. Iashvili
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Abstract

Background: Potentially lethal, aneurysmal subarachnoid hemorrhage has a bad prognosis for many individuals. Over the past few decades, endovascular and surgical interventions have been developed, including surgical clipping, and endovascular coiling. Patients who have aSAH are also susceptible to delayed cerebral ischemia and cerebral vasospasm. The aim of this study is to compare the outcome of endovascular coiling with surgical clipping in patients with SAH, specifically in relation to prevalence of vasospasm, in the country of Georgia. Method: In this study, we present a retrospective review of the outcomes of 217 patients with acute subarachnoid hemorrhage who underwent endovascular coiling or surgical clipping. The data were gathered from patients who are admitted to New Vision University Hospital and Caucasus Medical Center in Tbilisi, Georgia, between 2017 and 2022. Results: Vasospasm was prevalent in 217 of the patients who had aneurysmal rupture when they first appeared. Endovascular coiling or strated the most favorable option for treatment is endovascular coiling. However, the treatment choice takes multiple factors into account, and clipping is not ideal for some ruptured aneurysms. Despite the fact that endovascular coiling is usually successful and minimally invasive, complications can occur and additional monitoring and potential surgical intervention are indicated.
格鲁吉亚一例动脉瘤破裂后并发血管痉挛及其与手术夹持和血管内盘绕的关系
背景:动脉瘤性蛛网膜下腔出血对许多患者预后不良,具有潜在的致命性。在过去的几十年里,血管内和外科干预已经发展起来,包括手术夹持和血管内盘绕。aSAH患者也容易发生迟发性脑缺血和脑血管痉挛。本研究的目的是比较格鲁吉亚国家SAH患者的血管内盘绕和手术夹断的结果,特别是与血管痉挛的患病率有关。方法:回顾性分析217例急性蛛网膜下腔出血患者行血管内盘绕或手术夹闭治疗的结果。这些数据来自2017年至2022年期间在格鲁吉亚第比利斯新视觉大学医院和高加索医疗中心住院的患者。结果:217例动脉瘤破裂患者首次出现血管痉挛。血管内盘绕术是治疗的最佳选择。然而,治疗选择需要考虑多种因素,对于一些破裂的动脉瘤,夹闭并不理想。尽管血管内盘绕术通常是成功且微创的,但仍可能发生并发症,需要进行额外的监测和潜在的手术干预。
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