Comparison of Surgical Treatment And Endovascular Treatment of Intracranial Aneurysms

Abstract

Aim: The aim of the study is to compare endovascular and surgical treatment in patients with subarachnoid hemorrhage. Materials and Methods: Sixty-nine patients who applied our emergency service with subarachnoid hemorrhage, were classified according to their age, gender, risk factors, symptoms, localization of aneurysms, having single or multiple aneurysms and Fischer index. Results of surgical and endovascular treatment were evaluated according to time of intervention and ?Glaskow Coma Scale?. Neurologic status of patients evaluated according to ?Hunt-Hess scale? and ?WFNS grading system? at the time of application. The outcome of the patients defined with ?Glaskow Coma Scale?. Results: Result of surgery was better in patients who needed emergency intervention and operated between 24 hours and 5 days. Results of endovascular treatment were better in patients with stable neurological status, low grade Hunt-Hess scale, aneurysms with perforating branches. Conclusion: Although endovascular treatment reduces the morbidity and mortality with developing technology and techniques, surgery is still the first choice in patients who need urgent intervention.

Amaç: Acil servisimize basvuran ve anevrizmal subaraknoid kanama SAK tanisi alan hastalarin cerrahi ve endovasküler tedavilerinin karsilastirilmasi planlanmistir. Gereç ve Yöntem: Acil servisimize basvuran SAK?i bulunan veya klinik olarak anevrizma süphesi bulunan 69 hasta yas, cinsiyet, risk fatörleri, gelis klinik semptomlari, anevrizma lokalizasyonlari, tek veya birden fazla anevrizmaya sahip olusuna ve Fischer indeksine göre gruplandirildi. Cerrahi ve endovasküler tedavilerinin sonuçlari girisim zamanina ve ?Glaskow Koma Skoruna? GKS göre degerlendirildi. Olgularin gelis nörolojik tablolari ?Hunt-Hess? ve ?WFNS grade? ine göre, klinikten çikis durumlari ise GKS?ye göre degerlendirildi. Bulgular: Acil girisim gerektiren durumlarla beraber 24 saat- 5 gün arasi cerrahi sonuçlarini daha iyi saptadik. Nörolojik tablosu stabil, grade iyi olan hastalarda; cerrahi uygulanmasi zor, perforan dallari mevcut olan anevrizmalarda da 5-15 günler arasi endovasküler tedavinin sonuçlarini daha iyi bulduk. Sonuç: Ilerleyen teknoloji ve endovasküler tekniklerle daha yüksek sag kalim ve düsük morbidite oranlarinin endovasküler girisim lehine degisecegi kanisinda olsak da, acil durumlarda cerrahi girisimin her zaman ilk tercih olmasi düsüncesindeyiz.