- Yield of Repeat 3D Angiography in Patients with Aneurysmal-Type Subarachnoid Hemorrhage
The purpose of this study was to evaluate the yield of repeat 3D rotational angiography in patients with aneurysmal-type SAH with negative initial 3D rotational angiography findings. Between March 2013 andJanuary 2016, 292 patients with SAH and an aneurysmal bleeding pattern were admitted, with 30 having initial negative 3D rotational angiography findings within 24 hours. These patients underwent a second 3D rotational angiography after 7–10 days. In 8/30 patients (over 26%) with initial negative 3D rotational angiography findings, a ruptured aneurysm wasfound on repeat 3D rotational angiography. The investigators conclude that repeat 3D rotational angiography is mandatory in patients with initial 3D rotational angiography findings negative for aneurysmal-type SAH.
- Risk Factors for Ischemic Complications following Pipeline Embolization Device Treatment of Intracranial Aneurysms: Results from the IntrePED Study
This is a retrospective subanalysis of the IntrePED study, which has beenpreviously published (AJNR Am J Neuroradiol 2015;36:108–15).Seven hundred ninety-three patients with 906 treated aneurysms were enrolled. Thirty-six (4.5%) patients had postoperative acute ischemic stroke, 21 of which occurred within 1 week of the procedure. There was no difference in the rate of acute stroke between the anterior and posterior circulations. Stroke rate was 3% in patients with 1 PED, and 7% in those with 2 PEDs. With multivariate analysis, the only variable independently associated with postoperative stroke was treatment of fusiform aneurysms. Among the patients with stroke, 10 (27.0%) died and 26 (73.0%) had major neurologic morbidity. The authors conclude that acute ischemic stroke following treatment of intracranial aneurysms with the PED is an uncommon but devastating complication, with 100% of patients having major morbidity or mortality.
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