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A New Murine Model of Endovascular Aortic Aneurysm Repair
Published on: July 7, 2013
Risk and prognostic factors for intraprocedural rupture during endovascular treatment for unruptured intracranial
Katsunori Asai1, Toshiyuki Fujinaka2, Hajime Nakamura2
1From the Department of Neurosurgery (K.A., T.F.), NHO Osaka National Hospital, Osaka, Japan; Department of Neurosurgery (H.N., T.O.), The University of Osaka Graduate School of Medicine, Suita, Japan; Department of Neurosurgery (H.I.), National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurosurgery (A.I.), Juntendo University Hospital, Tokyo, Japan; Department of Neurosurgery (T.S.), Kindai University Hospital, Sakai, Japan; Department of Neurosurgery (S.Y.), Hyogo Medical University, Nishinomiya, Japan; Department of Neurosurgery (Y.M.), Institute of Medicine, University of Tsukuba, Tsukuba, Japan; Regulatory Science of Medical Device Development and Innovation (C.S.), Kyoto University, Graduate School of Medicine,Kyoto, Japan and Department of Neurosurgery (N.S.), Shimizu Hospital, Kyoto, Japan. asai-osk@umin.ac.jp.
Background And Purpose:
Intraprocedural rupture is a rare but serious complication during endovascular treatment for unruptured intracranial aneurysms. We aim to identify risk and prognostic factors for intraprocedural rupture using data from a nationwide registry in Japan.
Materials And Methods:
Data from 13,524 procedures were obtained. Poor clinical outcome was defined as a 30-day mRS score of 3-6. Logistic regression was used to determine predictors of intraprocedural rupture and poor clinical outcome after intraprocedural rupture.
Results:
Intraprocedural rupture occurred in 164 procedures (1.21%). Multivariate analysis showed that female sex (OR 2.27, 95% CI 1.48-3.50), remodeling balloon catheter use (OR 1.43, 95% CI 1.03-1.99), and anterior communicating artery (OR 2.40, 95% CI 1.55-3.70) and posterior communicating artery (OR 1.58, 95% CI 1.03-2.44) aneurysms were independently associated with intraprocedural rupture. Retreatment was associated with a lower risk for intraprocedural rupture(OR 0.36, 95% CI 0.16-0.82). Poor clinical outcomes and 30-day mortality were more frequent in the intraprocedural rupture group (17.9% and 4.88%, respectively).
Conclusions:
Intraprocedural rupture was associated with poor clinical outcomes. Identification of patients at high risk for intraprocedural rupture may help improve procedural safety and clinical outcomes.
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