Objective: Intracranial aneurysm is a kind of severe intracranial disease mainly responsible for subarachnoid hemorrhage, and the rupture of intracranial aneurysm results in a mortality rate of 30%-40%. For the first time in the world, this study aimed to assess the feasibility and efficacy of enhanced recovery after surgery (ERAS) protocol in Chinese elderly patients with intracranial aneurysm.
Methods: In this study, 300 elderly patients with intracranial aneurysm were recruited and divided into two groups as follows: ERAS group (n=150, ERAS protocol) and control group (n=150, conventional management).
Results: Age of whole cohort was 65 (64-67) years with 140 males (46.7). There was no difference between two groups in baseline features of patients, such as age, sex, medical histories, percentages of aneurysmal location, aneurysmal number >1 per patient, aneurysmal diameter >5 mm, or lobular aneurysm (>0.05 for all). There was no occurrence of death in two groups. Compared with those in the control group, patients in the ERAS group had significantly shorter length of hospital stay (<0.05). Between two groups, patients had not only similar Glasgow Outcome Scale (GOS) and Modified Rankin Scale (MRS) at discharge but also occurrence of readmission at follow-up (>0.05 for all). Patients in the ERAS group had significantly higher GOS and lower MRS at follow-up (<0.05 for all).
Conclusion: ERAS protocol significantly shortened the length of hospital stay and improved GOS and MRS without any increase in the mortality or readmission in Chinese elderly patients with intracranial aneurysm.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6350647 | PMC |
| http://dx.doi.org/10.2147/CIA.S187967 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Design and early progress of the Comparison of Anticoagulation and anti-Platelet Therapies for Intracranial Vascular Atherostenosis (CAPTIVA) trial.
Int J Stroke
January 2025
Medical University of South Carolina, Charleston, SC, USA.
Background: The usual antithrombotic treatment for symptomatic intracranial atherosclerotic stenosis (ICAS) consists of dual treatment with clopidogrel and aspirin for 90 days followed by aspirin alone but the risk of recurrent stroke remains high up to 12 months. The Comparison of Anticoagulation and anti-Platelet Therapies for Intracranial Vascular Atherostenosis (CAPTIVA) trial was designed to determine whether other combinations of dual antithrombotic therapy are superior to clopidogrel and aspirin.
Methods: CAPTIVA is an ongoing, prospective, double-blinded, three-arm clinical trial at over 100 sites in the United States and Canada that will randomize 1683 high-risk subjects with a symptomatic infarct attributed to 70-99% stenosis of a major intracranial artery to 12 months of treatment with (1) ticagrelor (180 mg loading dose, then 90 mg twice daily), (2) low-dose rivaroxaban (2.
Mechanical thrombectomy in elderly stroke patients with low ASPECTS: insights from STAR.
J Neurointerv Surg
January 2025
Department of Neurosurgery, Division of Neuroendovascular Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
Background: The elderly population (≥80 years) were underrepresented in recent trials of endovascular thrombectomy (EVT) for anterior circulation large vessel occlusion acute ischemic stroke (LVO-AIS) with low Alberta Stroke Program Early CT Score (ASPECTS) (≤5).
Methods: This study analyzed data from a prospectively maintained database of 37 thrombectomy centers. The primary cohort of the study comprised patients with LVO-AIS aged ≥80 who underwent EVT with ASPECTS≤5 from 2013 to 2023.
Competing pathways of intracranial aneurysm growth: linking regional growth distribution and hemodynamics.
J Neurosurg
January 2025
1Department of Bioengineering, George Mason University, Fairfax, Virginia.
Objective: The complex mix of factors, including hemodynamic forces and wall remodeling mechanisms, that drive intracranial aneurysm growth is unclear. This study focuses on the specific regions within aneurysm walls where growth occurs and their relationship to the prevalent hemodynamic conditions to reveal critical mechanisms leading to enlargement.
Methods: The authors examined hemodynamic models of 67 longitudinally followed aneurysms, identifying 88 growth regions.
Recurrence rate of intracranial aneurysms: a systematic review and a meta-analysis comparing craniotomy and endovascular coiling.
Neurosurg Rev
January 2025
Department of Neurosurgery, Sanya Central Hospital (Hainan Third People's Hospital）, No. 1154, Jiefang Road, Sanya City, Hainan Province, 572000, China.
Patients with intracranial aneurysm (IA) are at high risk of cerebral hemorrhage, which is associated with high mortality. Craniotomy or interventional endovascular coiling are common treatment methods in clinical practice, depending on the patient's condition. However, the recurrence rate of IA after either method remains unclear.
View Article and Find Full Text PDFIntracranial Aneurysms Treated with a Novel Coated Low-Profile Flow Diverter (p48 HPC)-A Single-Center Experience and an Illustrative Case Series.
Brain Sci
January 2025
Department of Diagnostic and Interventional Neuroradiology, School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany.
The p48 MW HPC is a novel low-profile flow diverter covered by a hydrophilic polymer coating with antithrombogenic properties, which may reduce ischemic complications and enable a single antiplatelet therapy after insertion of the stent. In this single-center experience, we describe the efficacy of this device, focusing on the illustration of different therapeutic indications and the outcome in various clinical settings with regard to vessel anatomy, bleeding state, and aneurysm configuration. We retrospectively reviewed our database for all patients being treated with a p48 MW HPC flow diverter between February 2019 and July 2021.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!