• World Neurosurg · May 2019

    Elective treatment of additional and recurrent aneurysms in patients with a previous subarachnoid hemorrhage: A single-center analysis of complications and clinical outcome.

    • Lukas Goertz, Gerrit Brinker, Christina Hamisch, Christoph Kabbasch, Jan Borggrefe, Marion Hof, Marco Timmer, Pantelis Stavrinou, Roland Goldbrunner, and Boris Krischek.
    • Center for Neurosurgery, Department of General Neurosurgery, University of Cologne, Kerpener Strasse, Cologne, Germany. Electronic address: lukas.goertz@uk-koeln.de.
    • World Neurosurg. 2019 May 1; 125: e1196-e1202.

    ObjectiveSubarachnoid hemorrhage (SAH) can be associated with a degree of resulting brain damage and subsequent reorganization of the central nervous system. The aim of this study was to evaluate complication rates and clinical outcome in patients with a previous SAH who were treated for a recurrent or an additional, initially unruptured aneurysm.MethodsA retrospective single-center study was conducted for patients who underwent elective treatment by surgical or endovascular means between 2010 and 2018. We compared patients with a previous SAH and without history of SAH in terms of complication rates and functional outcomes (modified Rankin Scale [mRS]).ResultsThe study population consisted of 337 patients (non-SAH, 270; SAH, 67) who underwent 390 elective procedures for treatment of 443 aneurysms. Procedure-related complications occurred in 13.5% of patients with a previous SAH and in 13.3% of patients without SAH (P = 1.0). At the 6-month follow-up, the morbidity (defined as any increase on the mRS) was comparable between the SAH group (6.7%) and the non-SAH group (7.6%; P = 0.5). Overall favorable outcome (mRS score ≤2) was achieved by 96.6% in the SAH group and 97.3% in the non-SAH group (P = 1.0). Also, in patients with a previous SAH, the choice of clipping or endovascular treatment did not have a significant impact on clinical outcome at the 6-month follow-up.ConclusionsTreatment of recurrent or additional aneurysms in patients with a previous SAH can be performed with acceptable complication rates and morbidity by either surgical or endovascular means.Copyright © 2019 Elsevier Inc. All rights reserved.

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