Endovascular Therapy for Aneurysm Bleeds

The results of a new study show that endovascular therapy can lead to significant recovery for patients with the most severe effects of aneurysm bleeds, called subarachnoid hemorrhage (SAH).

Cerebral aneurysms result from a weakened area in the blood vessel that causes a bulge in the vessel wall. When the bulge ruptures, a bleed occurs, which can cause severe disability or death. An endovascular treatment uses catheters to place platinum coils in the aneurysm, thereby blocking blood flow to the aneurysm and reducing the risk of rupture. The treatment has been proven as a good alternative to the more invasive practice of surgical clipping treatment.

The study was designed to evaluate the outcomes of endovascular treatment on patients with aneurysm ruptures who are suffering from coma, stupor, paralysis, or are otherwise too sick to undergo surgery. The study involved 111 poor-grade patients, who were all treated within 10 days of aneurysm bleeding, with 73 patients treated within three days of hemorrhage. Under radiologic guidance, a catheter was inserted directly into the groin and routed through the blood vessels leading to the brain. The coils were then introduced through the catheter and inserted directly into the affected area. Patients were also treated with aggressive medical management to maximize blood flow to the brain, typically safe only after the aneurysm is secured by coiling.

The patients were evaluated both at discharge and at 32 months following the aneurysm bleed. The results showed that 39 patients (35%) demonstrated favorable outcomes. The results were reported at the annual meeting of the American Society of Interventional and Therapeutic Neuroradiology in Hawaii (USA).

"I can safely say that this study can offer treating physicians, patients, and patients' families hope in the treatment possibilities even when patients' conditions are grave,” said co-author Gary Duckwiler, M.D., of the University of California at Los Angeles (UCLA, USA).





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