94 Chapter 5 More patients died after endovascular treatment (p=0.104) and fewer people were able to live independently after surgical treatment (p=0.084). However these differences were not statistically significant. Table 4. Clinical outcome Endovascular group Surgical group Number (%) Number (%) mRS 0 39 (25.7) 53 (28.3) 1 34 (22.4) 52 (27.8) 2 49 (32.2) 58 (31.0) 3 17 (11.2) 10 (5.3) 4 9 (5.9) 7 (3.7) 5 4 (2.6) 7 (3.7) Total 152 187 Imaging Table 5 shows the findings of post-procedural imaging. In the surgical group follow-up imaging was performed in 126 (63.3%) aneurysms, most of these within a year after surgery (88.9%). Post-procedural angiography showed complete occlusion in 101 (80.2%) aneurysms after surgical treatment, a residual neck in 17 (13.5%) and a residual aneurysm in 8 (6.3%) aneurysms. All aneurysms treated by endovascular therapy underwent postprocedural imaging at the end of the procedure. In 149 (61.1%) of these aneurysms complete occlusion was demonstrated, in 60 (24.6%) a residual neck, and in 35 (14.3%) a residual aneurysm. Complete aneurysm occlusion occurred significantly more often after surgical treatment compared to endovascular treatment (p<0.001). Table 5. Post-procedural angiography Surgical group Endovascular group n=199 Number (%) n=244 Number (%) No. of aneurysms with imaging 126 (64.8) 244 (100) Complete occlusion 101 (80.2) 149 (61.1) Residual neck 17 (13.5) 60 (24.6) Residual aneurysms 8 (6.3) 35 (14.3) No. of aneurysms without imaging 73 (35.2) 0 (0) Late imaging follow-up was available for a group of 38 surgically treated patients (24.8% of those surviving), harboring 50 aneurysms. The average interval between treatment and the last angiographic follow-up was 35.5 months (range, 10.3-105.5 months). Aneurysm regrowth was observed in 6 aneurysms (12.0%) after surgical treatment. Three of these cases had demonstrated a known residual aneurysm at earlier post-operative imaging. Four of these aneurysms had been primarily or additionally treated by coagulation or wrapping. Retreatment was performed in 4 of 199 (2.0%) aneurysms, in all cases after rebleeding. Because only a small group of surgically treated patients had follow-up imaging, no further results were obtained from this follow-up.
proefschrit Van Zwam inhoud met kaft en stellingen.indd
To see the actual publication please follow the link above