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The impact of endovascular management on the outcome of aneurysmal subarachnoid hemorrhage in the elderly in eastern Finland.
Acta Neurochir (Wien)
September 2010
Department of Neurosurgery, Kuopio University Hospital, Puijonlaaksontie 2, 70211 Kuopio, Finland.
Background: The International Subarachnoid Aneurysm Trial (ISAT) concluded that "there is currently no reason to doubt that the reduction of dependent survival or death after endovascular coiling seen in all patients in the ISAT cohort should not be valid in the elderly". We feel that this generalization requires further investigation to assess its validity.
Methods: We studied the impact of treatment era and independent risk factors for outcome in 179 consecutive elderly (> or =70 years) aneurysmal subarachnoid hemorrhage (aSAH) patients admitted to Kuopio University Hospital either between 1983 and 1992 (Era I, n = 56), prior to the introduction of endovascular management, or between 1995 and 2004 (Era II, n = 123) when the endovascular treatment was established at our institute.
International subarachnoid aneurysm trial 2009: endovascular coiling of ruptured intracranial aneurysms has no significant advantage over neurosurgical clipping.
Neurosurgery
May 2010
Department of Neurosurgery, University Medical Center Groningen, 9700 RB Groningen, The Netherlands.
In the May 2009 issue of The Lancet Neurology, the 5-year follow-up results of the International Subarachnoid Aneurysm Trial (ISAT) were published. The authors concluded that, although the significant difference between coiling and neurosurgical clipping of ruptured intracranial aneurysms in terms of death and severe disability after 1 year has vanished (primary endpoint), coiling should still be favored over neurosurgical clipping because mortality rates significantly favored coiling. In this commentary, it is this particular conclusion that is challenged by combining data from previous ISAT publications with the current 5-year follow-up results.
View Article and Find Full Text PDFHow much can be concluded from ISAT?
Br J Neurosurg
February 2007
Department of Neuroradiology, Greater Manchester Neurosciences Centre, Salford Royal NHS Foundation Trust, Hope Hospital, Salford, UK.
How much can be concluded from the International Subarachnoid Aneurysm Trial (ISAT)?
Br J Neurosurg
February 2007
Department of Neurosurgery, Hurstwood Park Neurosciences Centre, Haywards Heath, West Sussex, UK.
Recently published data from the International Subarachnoid Aneurysm Trial (ISAT) shows that for patients enrolled in the trial there is a 7.4% reduction in the incidence of death or dependency at 1 year if they undergo coiling, rather than clipping. Furthermore, extrapolation of longer-term follow-up data for patient mortality appears to suggest that this advantage will be maintained in the longer term.
View Article and Find Full Text PDFBody proportions in a medieval village population: effects of early childhood episodes of ill health.
Ann Hum Biol
September 1998
University of Odense, Denmark.
The purpose of this paper is to widen the observational basis for analysing growth patterns. To reach this aim measurements taken on skeletons from a small Danish village, Tirup, are analysed in relation to evidence for ill health in early childhood (age 1-6 years, inclusive). Enamel hypoplasia is taken as the indicator of health problems in this age range.
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