PMID- 38021017 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231201 IS - 2772-5294 (Electronic) IS - 2772-5294 (Linking) VI - 3 DP - 2023 TI - Adverse events during endovascular treatment of ruptured aneurysms: A prospective nationwide study on subarachnoid hemorrhage in Sweden. PG - 102708 LID - 10.1016/j.bas.2023.102708 [doi] LID - 102708 AB - INTRODUCTION: A range of adverse events (AEs) may occur in patients with subarachnoid hemorrhage (SAH). Endovascular treatment is commonly used to prevent aneurysm re-rupture. RESEARCH QUESTION: The aim of this study was to identify AEs related to endovascular treatment, analyze risk factors for AEs and how AEs affect patient outcome. MATERIAL AND METHODS: Patients with aneurysmal SAH admitted to all neurosurgical centers in Sweden during a 3.5-year period (2014-2018) were prospectively registered. AEs related to endovascular aneurysm treatment were thromboembolic events, aneurysm re-rupture, vessel dissection and puncture site hematoma. Potential risk factors for the AEs were analyzed using multivariate logistic regression. Functional outcome was assessed at one year using the extended Glasgow outcome scale. RESULTS: In total, 1037 patients were treated for ruptured aneurysms. Of which, 715 patients were treated with endovascular occlusion. There were 115 AEs reported in 113 patients (16%). Thromboembolic events were noted in 78 patients (11%). Aneurysm re-rupture occurred in 28 (4%), vessel dissection in 4 (0.6%) and puncture site hematoma in 5 (0.7%). Blister type aneurysm, aneurysm smaller than 5 mm and endovascular techniques other than coiling were risk factors for treatment-related AEs. At follow-up, 230 (32%) of the patients had unfavorable outcome. Patients suffering intraprocedural aneurysm re-rupture were more likely to have unfavorable outcome (OR 6.9, 95% CI 2.3-20.9). DISCUSSION AND CONCLUSION: Adverse events related to endovascular occlusion of a ruptured aneurysm were seen in 16% of patients. Aneurysm re-rupture during endovascular treatment was associated with increased risk of unfavorable functional outcome. CI - (c) 2023 The Authors. FAU - Baldvinsdottir, Bryndis AU - Baldvinsdottir B AD - Department of Clinical Sciences, Neurosurgery, Lund University, Lund, Sweden. FAU - Klurfan, Paula AU - Klurfan P AD - Department of Clinical Neuroscience, University of Gothenburg, Gothenburg, Sweden. FAU - Eneling, Johanna AU - Eneling J AD - Department of Clinical Sciences, Linkoping University, Linkoping, Sweden. FAU - Ronne-Engstrom, Elisabeth AU - Ronne-Engstrom E AD - Department of Neuroscience, Section of Neurosurgery, Uppsala University, Uppsala, Sweden. FAU - Enblad, Per AU - Enblad P AD - Department of Neuroscience, Section of Neurosurgery, Uppsala University, Uppsala, Sweden. FAU - Lindvall, Peter AU - Lindvall P AD - Department of Clinical Sciences, Umea University, Umea, Sweden. FAU - Aineskog, Helena AU - Aineskog H AD - Department of Clinical Sciences, Umea University, Umea, Sweden. FAU - Friethriksson, Steen AU - Friethriksson S AD - Department of Clinical Neuroscience, University of Gothenburg, Gothenburg, Sweden. FAU - Svensson, Mikael AU - Svensson M AD - Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. FAU - Alpkvist, Peter AU - Alpkvist P AD - Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. FAU - Hillman, Jan AU - Hillman J AD - Department of Clinical Sciences, Linkoping University, Linkoping, Sweden. FAU - Kronvall, Erik AU - Kronvall E AD - Department of Clinical Sciences, Neurosurgery, Lund University, Lund, Sweden. FAU - Nilsson, Ola G AU - Nilsson OG AD - Department of Clinical Sciences, Neurosurgery, Lund University, Lund, Sweden. LA - eng PT - Journal Article DEP - 20231110 PL - Netherlands TA - Brain Spine JT - Brain & spine JID - 9918470888906676 PMC - PMC10668086 OTO - NOTNLM OT - Adverse event OT - Aneurysm OT - Complication OT - Endovascular OT - Outcome OT - Subarachnoid hemorrhage COIS- The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2023/11/29 18:42 MHDA- 2023/11/29 18:43 PMCR- 2023/11/10 CRDT- 2023/11/29 14:55 PHST- 2023/08/27 00:00 [received] PHST- 2023/10/10 00:00 [revised] PHST- 2023/11/04 00:00 [accepted] PHST- 2023/11/29 18:43 [medline] PHST- 2023/11/29 18:42 [pubmed] PHST- 2023/11/29 14:55 [entrez] PHST- 2023/11/10 00:00 [pmc-release] AID - S2772-5294(23)00996-7 [pii] AID - 102708 [pii] AID - 10.1016/j.bas.2023.102708 [doi] PST - epublish SO - Brain Spine. 2023 Nov 10;3:102708. doi: 10.1016/j.bas.2023.102708. eCollection 2023.