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Fly and Treat: Endovascular Treatment of Ruptured Aneurysms at an Insular Tertiary Center

2023Journal article Open access
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dc.contributor.authorAlmeida Xavier, S
dc.contributor.authorRodrigues, A
dc.contributor.authorMeira, T
dc.contributor.authorMota Dória, H
dc.contributor.authorFigueira, C
dc.contributor.authorAmorim, J
dc.contributor.authorPestana, R
dc.contributor.authorNobrega, J
dc.contributor.authorFranco, J
dc.contributor.authorCarneiro, A
dc.date.accessioned2023-11-07T13:01:31Z
dc.date.available2023-11-07T13:01:31Z
dc.date.issued2023
dc.description.abstract(Objectives) Aneurysmal subarachnoid hemorrhage (aSAH) is a life-threatening condition associated with poor outcomes. Early intervention is critical, particularly in low-volume hospitals, which are advised to transfer aSAH patients to high-volume centers. This study examines a novel protocol implemented in 2016 at Região Autónoma da Madeira, a Portuguese island. It involves the mobilization of experienced neurointerventionalists from high-volume hospitals to provide aSAH treatment. (Methods) We conducted a retrospective analysis on 30 aSAH patients who underwent endovascular treatment at the island center between November 2016 and April 2022. Additionally, we included a comparison group of 74 aSAH patients, treated with the endovascular approach at Hospital de Braga (high volume center at Portugal mainland). (Results) There was no statistical difference in patients' clinical severity between both hospitals (median WFNS score of 1). Although 90 % of patients in the novel protocol group received treatment within 3 days, we observed a significant delay compared to Hospital de Braga. Rates of aneurysm occlusion and intra-procedure complications between the two groups were similar. At the 3-months follow-up, there were no statistically significant differences between groups regarding patients that achieved a modified Rankin score of 2 or less. However, the island center exhibited a significantly higher mortality rate. (Conclusions) Overall, our results suggest that making the neurointerventionalist fly to an insular center is feasible and allows most patients to be treated within the first 72 h, as recommended. We highlight some potential recommendations for implementing this model and discuss possible causes that might justify the high mortality rate.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationJ Stroke Cerebrovasc Dis . 2023 Oct 20;32(12):107390.pt_PT
dc.identifier.doi10.1016/j.jstrokecerebrovasdis.2023.107390pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/4742
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.subjectCHLC NRADpt_PT
dc.subjectAneurysm, Ruptured* / complicationspt_PT
dc.subjectAneurysm, Ruptured* / diagnostic imagingpt_PT
dc.subjectAneurysm, Ruptured* / therapypt_PT
dc.subjectHumanspt_PT
dc.subjectEndovascular Procedures* / adverse effects
dc.subjectEndovascular Procedures* / methods
dc.subjectIntracranial Aneurysm* / complications
dc.subjectIntracranial Aneurysm* / diagnostic imaging
dc.subjectIntracranial Aneurysm* / therapy
dc.subjectRetrospective Studies
dc.subjectTreatment Outcome
dc.subjectSubarachnoid Hemorrhage* / complications
dc.subjectSubarachnoid Hemorrhage* / diagnostic imaging
dc.subjectSubarachnoid Hemorrhage* / therapy
dc.titleFly and Treat: Endovascular Treatment of Ruptured Aneurysms at an Insular Tertiary Centerpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue12pt_PT
oaire.citation.startPage107390pt_PT
oaire.citation.titleJournal of Stroke and Cerebrovascular Diseasespt_PT
oaire.citation.volume32pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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