Rates of delayed rebleeding from intracranial aneurysms are low after surgical and endovascular treatment.

摘要: BACKGROUND AND PURPOSE Although results of the randomized International Subarachnoid Aneurysm Trial suggested that coil embolization was superior to surgical clipping 1 year after treatment, a paucity data on long-term outcomes has been major concern. METHODS In an ambidirectional cohort study, 9 institutions with expertise in intracranial aneurysm treatment identified all ruptured saccular aneurysms treated 1996 1998. After initial medical record review, patients meeting entry criteria were contacted by postal questionnaire or telephone. Possible reruptures adjudicated independently neurologist, neurosurgeon, and neurointerventional radiologist. Rates delayed (>1 year) early rerupture retreatment evaluated using Kaplan-Meier survival analysis log-rank test. RESULTS A total 1010 (711 surgically clipped, 299 embolization) included. Patients older, more likely have smaller arising from posterior circulation, less middle cerebral artery aneurysms. Rerupture index occurred patient during 904 person-years follow-up (annual rate 0.11%) no 2666 (P=0.11). frequent (P<0.0001), but complications rare retreatment. CONCLUSIONS either is first year. Late common than complication rates are low. Thus, late events unlikely overwhelm differences between procedures at 1-year follow-up.