Abstract W P85: Immediate Balloon Assistance Leads to Improved Outcomes Following Intraprocedural Aneurysmal Ruptures
Introduction: Aneurysms are balloon-like outpouchings of weakened arterial walls which can rupture and cause severe complications in patients, including subarachnoid hemorrhaging and hydrocephalus. Current treatment for cerebral aneurysms include surgical clipping or interventional radiology procedures using coiling or stenting.
Aims: Our study aimed to (1) note the vital sign changes leading up to an intraprocedural aneurysmal rupture and (2) determine whether or not patients who received immediate balloon assistance upon rupture fared better than those who did not.
Hypothesis: We assessed the hypothesis that 1) there will be significant spikes in heart rate and systolic blood pressure upon rupture and that (2) patients receiving immediate balloon assistance fared better post-procedurally.
Methods: A single institution retrospective analysis of all intraprocedural aneurysmal ruptures from July of 2009 to present day at the Medical University of South Carolina was utilized.
Results: In this time period, 13 intraprocedural aneurysmal ruptures occurred in 8 female and 5 male patients. In 9 cases, rupture was directly attributable to aneurysm perforation via coil or microcatheter. Heart rate spikes immediately upon rupture averaged -1.63 bpm +/- 10.8 while systolic blood pressure spikes averaged 12.7 mmHg +/- 11.6. Balloon assistance was available for 10 ruptures. Balloon inflation was the sole method of rupture treatment for 4 patients, 1 was treated via protamine injection to reverse heparinization, and 5 were treated with a combination of these. Of the 5 patients whose CT scans remained unchanged from baseline rather than indicating an increase in hemorrhage or hydrocephalus, all had a balloon available for immediate inflation and all were discharged with no need for a ventriculostomy and no neurological deficits.
Conclusions: Our limited sample size suggests that a significant heart rate and systolic blood pressure spike does not appear to consistently occur upon aneurysmal rupture. A larger sample size is necessary to further explore vital sign changes. Balloon assisted embolization procedures tend to produce better clinical outcomes in instances of intraprocedural rupture. Future directions will involve expanding to more institutions.
Author Disclosures: R. Peneva: None. B. Kalan: None. A. Spiotta: None.
- © 2015 by American Heart Association, Inc.