Comparison of Surgical Treatment And Endovascular Treatment of Intracranial Aneurysms

Yıl 2018, Cilt: 10 Sayı: 1, 24 - 31, 01.04.2018

İbrahim Alataş Hüseyin Canaz

Öz

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.

Anahtar Kelimeler

Cerebral aneurysms, endovascular treatment, surgical treatment

İntrakraniyal Anevrizmalarda Cerrahi Tedavi İle Endovasküler Tedavinin Karşılaştırılması

Öz

Amaç: Acil servisimize başvuran ve anevrizmal subaraknoid kanama SAK tanısı alan hastaların cerrahi ve endovasküler tedavilerinin karşılaştırılması planlanmıştır. Gereç ve Yöntem: Acil servisimize başvuran SAK’ı bulunan veya klinik olarak anevrizma şüphesi bulunan 69 hasta yaş, cinsiyet, risk fatörleri, geliş klinik semptomları, anevrizma lokalizasyonları, tek veya birden fazla anevrizmaya sahip oluşuna ve Fischer indeksine göre gruplandırıldı. Cerrahi ve endovasküler tedavilerinin sonuçları girişim zamanına ve “Glaskow Koma Skoruna” GKS göre değerlendirildi. Olguların geliş nörolojik tabloları “Hunt-Hess” ve “WFNS grade” ine göre, klinikten çıkış durumları ise GKS’ye göre değerlendirildi. Bulgular: Acil girişim gerektiren durumlarla beraber 24 saat- 5 gün arası cerrahi sonuçlarını daha iyi saptadık. Nörolojik tablosu stabil, grade iyi olan hastalarda; cerrahi uygulanması zor, perforan dalları mevcut olan anevrizmalarda da 5-15 günler arası endovasküler tedavinin sonuçlarını daha iyi bulduk. Sonuç: İlerleyen teknoloji ve endovasküler tekniklerle daha yüksek sağ kalım ve düşük morbidite oranlarının endovasküler girişim lehine değişeceği kanısında olsak da, acil durumlarda cerrahi girişimin her zaman ilk tercih olması düşüncesindeyiz.

Anahtar Kelimeler

Cerrahi tedavi, endovasküler tedavi, serebral anevrizma

Kaynakça

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