Universität zu Köln

Lenschow, Moritz, von Spreckelsen, Niklas, Telentschak, Sergej, Kabbasch, Christoph, Goldbrunner, Roland and Grau, Stefan (2022). Ventriculostomy-related intracranial hemorrhage following surgical and endovascular treatment of ruptured aneurysms. Neurosurg. Rev., 45 (4). S. 2787 - 2796. NEW YORK: SPRINGER. ISSN 1437-2320

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Abstract

Endovascular therapy of ruptured aneurysms is regularly accompanied by periprocedural heparinization and requires the use of periprocedural antiplatelets in more complex cases. This raises concerns regarding increased bleeding risks in the case of frequently required ventriculostomy. The aim of this study was to analyze risk factors for ventriculostomy-related intracranial hemorrhages (VS-ICH) in endovascular or surgical treatment of ruptured aneurysms with a focus on antithrombotic therapy. In this retrospective analysis, we included patients admitted to our institution over a 12-year period who had received at least one ventriculostomy due to subarachnoid hemorrhage-related hydrocephalus. Patients were dichotomized into an endovascular and surgical group and rates of VS-ICH were compared. Risk factors for VS-ICH were assessed in uni- and multivariate analyses. A total of 606 ventriculostomies were performed in 328 patients. Within the endovascular group, antiplatelet therapy was used in 44.8% of cases. The overall rate of ventriculostomy-related intracranial hemorrhage was 13.1%. Endovascular treatment was associated with a higher rate of VS-ICH compared to surgical treatment (p = 0.011), but not in cases without antiplatelet therapy (p = 0.166). Application of any antiplatelet therapy (odds ratio, 2.647 [95% confidence interval, 1.141-6.143]) and number of ventriculostomies (odds ratio, 2.513 [95% confidence interval, 1.859-3.395]) were independent predictors of ventriculostomy-related hemorrhages. Our findings indicate an increased risk of VS-ICH in the endovascular group if administration of antiplatelets was required. While this aspect has to be included into treatment decision-making, it must be weighed against the benefits of endovascular techniques.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Lenschow, Moritz UNSPECIFIED UNSPECIFIED UNSPECIFIED von Spreckelsen, Niklas UNSPECIFIED UNSPECIFIED UNSPECIFIED Telentschak, Sergej UNSPECIFIED UNSPECIFIED UNSPECIFIED Kabbasch, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Goldbrunner, Roland UNSPECIFIED UNSPECIFIED UNSPECIFIED Grau, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-659676
DOI:	10.1007/s10143-022-01777-5
Journal or Publication Title:	Neurosurg. Rev.
Volume:	45
Number:	4
Page Range:	S. 2787 - 2796
Date:	2022
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1437-2320
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language STENT-ASSISTED COILING; SUBARACHNOID HEMORRHAGE; SAFETY; EMBOLIZATION; PLACEMENT; TIROFIBAN; TIME Multiple languages Clinical Neurology; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/65967