[Efficacy and safety of endovascular treatment of brain aneurysms: experience in our setting].
INTRODUCTION: The objective of our study is to know the efficacy and safety of endovascular treatment in our setting. PATIENTS AND METHODS: a) prospective evaluation of patients with aneurysmal subarachnoid hemorrhage (SAH) or incidental aneurysm (Dec 1999-Dec 2002), and b) neurological, angiographic and evolutive evaluation of the endovascularly operated patients. RESULTS: A total of 79 patients were evaluated: 75 with SAH, 4 with incidental aneurysm. Arteriographies were performed in 74 (93.6%), detecting 58 aneurysms in 52 patients, 15 of the anterior communicating artery (25%) and 14 of the posterior communicating artery (24%). Fifty-two aneurysms were treated with Guglielmi Detachable Coiling (GDC) (89.6 %). Total occlusion (100 %) was obtained in 48 (82.7%) and partial occlusion in 4. Technique failure occurred in six cases. The earlier complications, after endovascular procedure (< 24 h), were one rebleeding, four angiographic spasms and ischemia and one coil displacement. During the first month, there were other cases of rebleeding and two cases of spasm and ischemia. Morbidity rate was 11.5 %. Death rate was 5.7 %. Follow-up period ranges between 6 and 42 months. After endovascular treatment 40 patients had a favourable outcome (Ranking 1-2) and 9 suffered moderate-severe incapacity (Ranking 3-5). We prescribed angiographic controls one year after the hemorrhagic event and there was only one case of aneurysmal recurrence. DISCUSSION: In our experience endovascular treatment is useful to treat ruptured and unruptured aneurysms, with similar surgical occlusion, morbidity and death rates.