Summary
This thesis was designed aiming at covering the following areas in the theoretical part : (1) Intracranial aneurysms , (2) Subarachnoid hemorrhage, (3) Management of subarachnoid hemorrhage, (4) Endovascular treatment of intracranial aneurysms.
The practical part aimed at comparing immediate outcome, intraprocedural complication and radiological and clinical follow-up of endovascular coiling of very small (≤ 3 mm), small (> 3-6 mm), medium (> 6-12 mm) and large (> 12–25 mm) ruptured intracranial aneurysms.
The present study includes thirty eight patients with ruptured intracranial aneurysms of different sizes (< 25 mm) who underwent endovascular treatment from 2015 to 2017, attending Benha University Hospital.
We obtained an informed consent and inclusion criteria were insured before the study.
The tools were carefully selected to serve for the purpose of the study, this included: (1) Clinical presentation, (2) Aneurysm characteristics (3) Endovascular procedure (4) Follow up.
The present study showed that:
• The mean age of the included patients was 53.263 ±12.2 years; while the majority of them were females (55.3%).
• 78.9% of the patients underwent simple coil, 15.8% underwent balloon-assisted coiling, and 5.3% underwent stent-assisted coiling. The procedure was successful in 97.4% of the patients and there was an adequate occlusion in 86.5% of them. Regarding the results of follow-up, 86.1% of the patients had adequate occlusion during radiological examination. In addition, 88.9% had stable or improved condition. The mean Modified Rankin scale (mRS) was 1.26 ±1.4.
• There were no significant association between size of aneurysm with age, gender, Hunt and H (H&H) score, FISHER score or with neck width or dome-to-neck ratio .
• There were no significant associations between size of aneurysm with modality of treatment .
• There were statistically significant associations between modality of treatment with neck size and dome-to-neck ratio.
• There was no significant association between size of aneurysm and feasibility or immediate postoperative results .
• There were no significant associations between immediate postoperative results and age, gender, location of aneurysm, H & H score or FISHER score.
• There was no significant association between immediate postoperative results and neck size. In contrary, there was statistically significant association between immediate postoperative results and neck dome-to-neck ratio.
• There was no significant association between immediate postoperative results and modality of treatment .
• There was no significant association between aneurysm size and the complications rate .
• There was statistically significant association between complications rates and age and with H & H score. In contrary, there was no significant association between complications rates and gender, location of aneurysm, FISHER score, neck size, dome-to-neck ratio or procedure used.
• There was no statistically significant association between aneurysm size and the results of radiological follow-up .
• Additionally, there were no statistically significant associations between radiological follow-up and the age, gender, location of aneurysm, H & H score or FISHER score.
• On the contrary, there was statistically significant association between radiological follow-up with the neck width and dome-to-neck ratio.
• In addition, there was no statistically significant association between radiological follow-up and the modality of treatment or the immediate postoperative results.
• There was no statistically significant association between evolution of aneurysm occlusion and the size of aneurysm.
• There was no statistically significant association between evolution of aneurysm occlusion and age, gender, location of aneurysm, H & H score or FISHER score.
• There was statistically significant association between evolution of aneurysm occlusion and neck size and dome-to-neck ratio .
• There was statistically significant association between evolution of treatment and modality of treatment and immediate postoperative results
• There was no statistically significant association between mRs and size of aneurysm .
• There was statistically significant association between mRs and H & H score and rate of complications .
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