Endovascular treatment of cerebral aneurysms at a low-volume community hospital practice: management strategies, complications, and outcomes

J Neuroimaging. 2012 Jul;22(3):233-42. doi: 10.1111/j.1552-6569.2011.00630.x. Epub 2011 Aug 17.

Abstract

Background and purpose: Our institution serves a population of 160,000 and performed 14.4 endovascular cerebral aneurysm interventions annually, averaged over a 5-year period. The purpose of this study was to examine the safety and efficacy of endovascular treatment of cerebral aneurysms at a lowvolume center.

Methods: Retrospective cohort analysis of 56 patients harboring 64 aneurysms requiring 72 procedures over 62 months. Aneurysm morphology, procedure-related adverse events and clinical outcomes were analyzed.

Results: Twenty-two ruptured (34.4%) and 42 unruptured (65.6%) aneurysms were treated in 12 males (mean age 61.1 years), 44 females (mean age 61.8 years). The procedure-related morbidity and mortality was 6.9% (5 of 72) and 1.3% (1 of 72 procedures), respectively. Modified Rankin Scale score was 0 or 1 in 87.9% of all discharges (61.9% in the ruptured group, 100% in the unruptured group). This score was between 2 to 5 in 7.6% (23.8% ruptured, 0% ruptured) and 6 in 4.3% of patients. Seventy-two percent of aneurysms demonstrated complete occlusion initially, 23.0% had residual neck filling, and 4.9% had residual aneurysm filling.

Conclusion: Endovascular coil embolization at a small volume nonspecialized community center is feasible with satisfactory procedural risk and clinical outcomes.

MeSH terms

  • Adult
  • Endovascular Procedures / mortality*
  • Female
  • Hospitals, Community / statistics & numerical data*
  • Humans
  • Illinois / epidemiology
  • Intracranial Aneurysm / diagnostic imaging
  • Intracranial Aneurysm / mortality*
  • Intracranial Aneurysm / surgery*
  • Male
  • Middle Aged
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / mortality*
  • Prevalence
  • Prognosis
  • Radiography
  • Risk Factors
  • Survival Analysis
  • Survival Rate
  • Treatment Outcome