Experience in endovascular management of aneurysms with coils in a Peruvian referral hospital: a therapeutic challenge
DOI:
https://doi.org/10.59156/revista.v40i01.776Keywords:
Endovascular aneurysm repair, Intracranial aneurysm, Neurosurgery, Subarachnoid hemorrhageAbstract
Background: unruptured cerebral aneurysms have an incidence of 5-10%, and their rupture causes up to 98% of spontaneous subarachnoid hemorrhages, with high morbidity and mortality. Endovascular advances allow for various embolization techniques aimed at achieving better occlusion and reducing recanalization.
Objectives: to evaluate the effectiveness and clinical-angiographic outcomes of simple coiling, balloon-assisted, and stent-assisted coiling in patients with cerebral aneurysms treated in our Institution.
Methods: a descriptive, retrospective study of 61 patients treated with endovascular embolization was conducted. Clinical, angiographic, and functional variables were analyzed using the Raymond-Roy and modified Rankin scales.
Results: females predominated (73.7%), with a mean age of 56.1 years. The most frequent location was the posterior communicating artery (27.8%). Simple embolizations were performed using coils (29.5%), balloon-assisted embolization (39.3%), and stent-assisted embolization (31.1%). Recanalization was more frequent with coils alone (41.1%) compared to balloon (4.1%) and stent (5.2%) (p<0.01). Overall mortality was 3.2%, and 81.9% of patients had a favorable functional outcome (Rankin 0-2).
Conclusion: Balloon- and stent-assisted techniques showed better angiographic stability, lower recanalization rates, and lower morbidity and mortality compared to coil-only embolization. Optimizing the stroke-to-coil time and decentralizing specialized centers are needed to improve functional and survival outcomes in patients with cerebral aneurysms.
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