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首页> 外文期刊>Acta Neurochirurgica >Increased rate of ventriculostomy-related hemorrhage following endovascular treatment of ruptured aneurysms compared to clipping
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Increased rate of ventriculostomy-related hemorrhage following endovascular treatment of ruptured aneurysms compared to clipping

机译：与剪切相比，在血管内治疗破裂动脉瘤后血管内治疗后胃窦相关出血率增加

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Abstract Objective Acutely ruptured aneurysms can be treated by endovascular intervention or via surgery (clipping). After endovascular treatment, the risk of thromboembolic complications is reduced by the use of anticoagulative agents, which is not required after clipping. The aim of the study is to investigate the rate of ventriculostomy-related hemorrhage after endovascular treatment and clipping. Methods A consecutive series of 99 patients treated for a ruptured aneurysm which required an external ventricular drainage between 2010 and 2015 were included. Their CT scans were investigated retrospectively for ventriculostomy-related hemorrhage. Furthermore, the extent of bleeding, the rate of revision surgery, and the rate of bacterial ventriculitis have been analyzed. Results Ventriculostomy-related hemorrhage was observed in 20 of 45 patients after endovascular treatment compared to 7 of 54 patients after clipping (chi-squared test, p ? p ?=?0.003). Glasgow outcome scale showed a significant better outcome in the surgical group ( t test, p ?=?0.005). Conclusions Ventriculostomy-related hemorrhage is an underestimated complication after endovascular treatment leading to revision surgeries, bacterial infections, and may have a negative impact on long-term outcome. The probability of occurrence is increased when anticoagulation is performed by heparin in combination with antiplatelet drugs as compared to heparin alone. Lumbar drainage should be considered as an alternative for treatment of acute hydrocephalus in patients with Hunt and Hess grade 1–3.
机译：摘要客观急性破裂的动脉瘤可以通过血管内干预或通过手术治疗（剪切）治疗。在血管内治疗后，通过使用抗凝血剂减少血栓栓塞并发症的风险，抗凝剂是剪切后不需要的。该研究的目的是探讨血管内治疗和剪裁后的肠胃术过出血的速率。方法采用连续系列99例治疗2010年至2015年间的破裂动脉瘤治疗的患者。他们的CT扫描被回顾性地调查了肠胃术相关的出血。此外，已经分析了出血程度，修正手术率和细菌性心室炎的速率。结果在血管内治疗后20例患者中观察到肠胃术相关的出血，而夹持后的7例患者中的7名（Chi-Squared试验，P≥1.003）。格拉斯哥结果规模显示出在手术组中具有显着的更好结果（T试验，P？= 0.005）。结论肠胃术相关的出血是血管内治疗后的低估并发症，导致修改手术，细菌感染，可能对长期结果产生负面影响。当肝素组合与单独的肝素相比，肝素与抗血小板药物组合进行时，发生发生的概率。腰带引流应被视为治疗亨特和Hess级1-3患者急性脑积水的替代方案。

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