Procedural complications of endovascular treatment in patients with aneurysmal subarachnoid haemorrhage treated at a single centre

Abstract

Background: We present a single-centre experience of procedural complications suffered by patients undergoing endovascular treatment for a ruptured saccular intracranial aneurysm at Tampere University Hospital, Finland, between 2000 and 2014.

Method: From 2000 to 2014, we treated 1,253 patients with aneurysmal subarachnoid haemorrhage, 491 of whom received endovascular treatment. Clinical data were collected retrospectively from the hospital's aneurysm database. A procedural complication was defined as having occurred whenever there was a documented new event in the patient's medical records or a note of a technical complication written by an interventionist after endovascular treatment. Procedural complications could be with or without clinical symptoms.

Results: Nearly 40% (491/1253) of the patients were treated with the endovascular method. Procedural complications occurred in 11.4% (56/491) of cases. The morbidity rate was 4.5% (22/491) and the mortality rate was 0.2% (1/491). Of the 56 complications, ischaemic complications occurred in 52% (29/56), haemorrhagic complications occurred in 27% (15/56) and technical complications occurred in 21% (12/56) of cases. In 61% (34/56) of the cases, the procedural complication did not cause any clinical symptoms.

Conclusions: The total risk for procedural complications leading to postoperative disability or death at our institute was 4.7%. The complication frequency is in accordance with previous reports. Endovascular treatment of ruptured intracranial aneurysms is a safe treatment method when patient selection is carefully performed.

Keywords: Aneurysm; Endovascular treatment; Intracranial aneurysm; Procedural complications; Subarachnoid haemorrhage; Treatment.