The complications during endovascular treatment of cerebral aneurysms in acute and delayed period of subarachnoid hemorrhage

Abstract

Objective: to describe and analyze the character, causes and frequency of various complications during endovascular occlusions (EVO)of cerebral aneurysms in acute and delayed periods of subarachnoid hemorrhage (SAH). Materials and methods: We performed EVO at 180 patients with ruptured cerebral aneurysms from 01.12.2007 till 31.07.2012; among them 74 patients were operated on in acute period of SAH (AP of SAH) (within 2 weeks from aneurysm rupture) and 106 patients - in delayed period of SAH (DP of SAH). Results: Aneurysm rupture during endovascular procedure was seen at 8 (10,8%) patients, operated on in AP of SAH and at 4 (3,7%) patients operated on in DP of SAH. The thromboembolic complications were seen at 11 (14,8%) patients in AP of SAH and at 6 (5,6%) patients in DP of SAH. The postoperative lethality was 9,45% in AP of SAH and 0,94% - in DP of SAH. Conclusion. The risk for development of hemorrhagic and thromboembolic complications is higher during EVO of ruptured aneurysms at patients in AP of SAH comparing with the those in DP of SAH. The risk factors for aneurysms rupture during EVO were aneurysm localization on anterior cerebral-anterior communicating arteries (ACA-ACoA) and on middle cerebral artery as well as the aneurysm size less than 4 mm. The thromboembolic complications were more often seen at patients with ACA-ACoA aneurysms and aneurysm size within 5-10 mm.