Complicaciones en pacientes mayores de 70 años bajo tres opciones terapéuticas para aneurisma intracerebral no roto, en dos centros de atención de Bogotá, Colombia. 2016 – 2020
Thesis
Subarachnoid hemorrhage (SAH) is currently one of the neurosurgical pathologies with the highest morbidity and mortality, with an approximate rate of SAH of aneurysmal origin of 16%. An aneurysm is an abnormal vascular dilation which can cause alteration in the muscular and adventitial layers of the blood vessel, thus making it susceptible to rupture. Some of these are present even without rupture, with an approximate incidence of 1-6% and an annual risk of rupture of 2% of the general population, representing high costs in comprehensive rehabilitation for our health systems. The management for this condition offers 2 alternatives, surgical therapy for aneurysmal clipping, and endovascular therapy where the embolization technique is used to correct the aneurysmal defect. However, there are some exceptions that currently generate great controversy in their management, such as the approach to incidental intracerebral aneurysm in older adult patients (older than 65 years). At present we do not have studies that support one technique or another, considering that the surgical risk is estimated at approximately 10% vs endovascular risk close to 2%, and the risk of annual rupture is much lower than these two techniques. The question arises here, if any benefit is achieved by subjecting these patients to intraoperative risk, or if the best alternative is to consider expectant management. This study will help us to determine with our own Latin idiosyncrasy patients, what is the estimated risk of real rupture in our population, what is the real risk that each procedure presents, and what is the most appropriate technique to approach this condition.
publication date
July 27, 2021 1:02 AM
Research
keywords
Comparison of risks in Neurosurgery versus therapeutic embolization
Evaluation of clinical risks in the treatment of Aneurysm
Evaluation of procedures in the treatment of aneurysms aimed at preventing subarachnoid hemorrhages
Risk analysis of subarachnoid hemorrhage (SAH) in embolization vs microsurgical clipping
