Evaluación del pronóstico y complicaciones del tratamiento, según el tamaño de los aneurismas intracraneales de los pacientes que debutan con hemorragia subaracnoidea en la Clínica Foscal en el periodo de enero de 2014 a marzo de 2019
La hemorragia subaracnoidea (HSA) es causada principalmente por la ruptura de aneurismas intracraneales. Se han descrito importantes factores de riesgo como la edad, el sexo, el tabaquismo, la hipertensión (HTA), el tamaño de los aneurismas y la estación del año, entre otros. La mortalidad es de has...
- Autores:
-
Sotomayor Rubio, Arístides Jesús
- Tipo de recurso:
- Fecha de publicación:
- 2021
- Institución:
- Universidad Autónoma de Bucaramanga - UNAB
- Repositorio:
- Repositorio UNAB
- Idioma:
- spa
- OAI Identifier:
- oai:repository.unab.edu.co:20.500.12749/13958
- Acceso en línea:
- http://hdl.handle.net/20.500.12749/13958
- Palabra clave:
- Medical sciences
Health sciences
Subarachnoid hemorrhage
Head trauma
Intracranial hemorrhage
Aneurysms
Cerebrovascular disorders
Ciencias médicas
Hemorragia intracraneal
Aneurismas
Trastornos cerebrovasculares
Ciencias de la salud
Hemorragia subaracnoidea
Traumatismo craneoencefálico
- Rights
- openAccess
- License
- http://creativecommons.org/licenses/by-nc-nd/2.5/co/
id |
UNAB2_6136956e2163865b45c76f1fd1366385 |
---|---|
oai_identifier_str |
oai:repository.unab.edu.co:20.500.12749/13958 |
network_acronym_str |
UNAB2 |
network_name_str |
Repositorio UNAB |
repository_id_str |
|
dc.title.spa.fl_str_mv |
Evaluación del pronóstico y complicaciones del tratamiento, según el tamaño de los aneurismas intracraneales de los pacientes que debutan con hemorragia subaracnoidea en la Clínica Foscal en el periodo de enero de 2014 a marzo de 2019 |
dc.title.translated.spa.fl_str_mv |
Evaluation of the prognosis and complications of the treatment, according to the size of the intracranial aneurysms of the patients presenting with subarachnoid hemorrhage at the Foscal Clinic in the period from January 2014 to March 2019 |
title |
Evaluación del pronóstico y complicaciones del tratamiento, según el tamaño de los aneurismas intracraneales de los pacientes que debutan con hemorragia subaracnoidea en la Clínica Foscal en el periodo de enero de 2014 a marzo de 2019 |
spellingShingle |
Evaluación del pronóstico y complicaciones del tratamiento, según el tamaño de los aneurismas intracraneales de los pacientes que debutan con hemorragia subaracnoidea en la Clínica Foscal en el periodo de enero de 2014 a marzo de 2019 Medical sciences Health sciences Subarachnoid hemorrhage Head trauma Intracranial hemorrhage Aneurysms Cerebrovascular disorders Ciencias médicas Hemorragia intracraneal Aneurismas Trastornos cerebrovasculares Ciencias de la salud Hemorragia subaracnoidea Traumatismo craneoencefálico |
title_short |
Evaluación del pronóstico y complicaciones del tratamiento, según el tamaño de los aneurismas intracraneales de los pacientes que debutan con hemorragia subaracnoidea en la Clínica Foscal en el periodo de enero de 2014 a marzo de 2019 |
title_full |
Evaluación del pronóstico y complicaciones del tratamiento, según el tamaño de los aneurismas intracraneales de los pacientes que debutan con hemorragia subaracnoidea en la Clínica Foscal en el periodo de enero de 2014 a marzo de 2019 |
title_fullStr |
Evaluación del pronóstico y complicaciones del tratamiento, según el tamaño de los aneurismas intracraneales de los pacientes que debutan con hemorragia subaracnoidea en la Clínica Foscal en el periodo de enero de 2014 a marzo de 2019 |
title_full_unstemmed |
Evaluación del pronóstico y complicaciones del tratamiento, según el tamaño de los aneurismas intracraneales de los pacientes que debutan con hemorragia subaracnoidea en la Clínica Foscal en el periodo de enero de 2014 a marzo de 2019 |
title_sort |
Evaluación del pronóstico y complicaciones del tratamiento, según el tamaño de los aneurismas intracraneales de los pacientes que debutan con hemorragia subaracnoidea en la Clínica Foscal en el periodo de enero de 2014 a marzo de 2019 |
dc.creator.fl_str_mv |
Sotomayor Rubio, Arístides Jesús |
dc.contributor.advisor.none.fl_str_mv |
Mantilla García, Daniel Eduardo Ochoa Vera, Miguel Enrique |
dc.contributor.author.none.fl_str_mv |
Sotomayor Rubio, Arístides Jesús |
dc.contributor.cvlac.spa.fl_str_mv |
Mantilla García, Daniel Eduardo [0001437130] Ochoa Vera, Miguel Enrique [0000898465] |
dc.contributor.googlescholar.spa.fl_str_mv |
Mantilla García, Daniel Eduardo [PUqdPK8AAAAJ&hl=es&oi=ao] |
dc.contributor.orcid.spa.fl_str_mv |
Mantilla García, Daniel Eduardo [0000-0002-5727-3195] Ochoa Vera, Miguel Enrique [0000-0002-4552-3388] |
dc.contributor.researchgate.spa.fl_str_mv |
Ochoa Vera, Miguel Enrique [Miguel-Enrique-Ochoa-2186675588] |
dc.subject.keywords.spa.fl_str_mv |
Medical sciences Health sciences Subarachnoid hemorrhage Head trauma Intracranial hemorrhage Aneurysms Cerebrovascular disorders |
topic |
Medical sciences Health sciences Subarachnoid hemorrhage Head trauma Intracranial hemorrhage Aneurysms Cerebrovascular disorders Ciencias médicas Hemorragia intracraneal Aneurismas Trastornos cerebrovasculares Ciencias de la salud Hemorragia subaracnoidea Traumatismo craneoencefálico |
dc.subject.lemb.spa.fl_str_mv |
Ciencias médicas Hemorragia intracraneal Aneurismas Trastornos cerebrovasculares |
dc.subject.proposal.spa.fl_str_mv |
Ciencias de la salud Hemorragia subaracnoidea Traumatismo craneoencefálico |
description |
La hemorragia subaracnoidea (HSA) es causada principalmente por la ruptura de aneurismas intracraneales. Se han descrito importantes factores de riesgo como la edad, el sexo, el tabaquismo, la hipertensión (HTA), el tamaño de los aneurismas y la estación del año, entre otros. La mortalidad es de hasta el 50%, hasta un 30% permanecen con secuelas graves y sólo un 30% pueden desarrollar sus actividades de forma independiente. La HSA requiere tratamiento inmediato para evitar nuevos eventos de sangrado. Actualmente no hay estudios de HSA en nuestra región evaluando la relación del tamaño de los aneurismas con los riesgos del tratamiento . Este estudio de cohorte retrospectivo se basa en el análisis de datos secundarios anonimizados, y el objetivo es evaluar la asociación entre el pronóstico y las complicaciones del tratamiento, con el tamaño de los aneurismas intracraneales de los pacientes atendidos con hemorragia subaracnoidea en la clínica FOSCAL en el periodo de enero de 2014 a marzo de 2019. Se realizará una descripción de las variables y análisis bivariado. |
publishDate |
2021 |
dc.date.accessioned.none.fl_str_mv |
2021-08-23T18:27:56Z |
dc.date.available.none.fl_str_mv |
2021-08-23T18:27:56Z |
dc.date.issued.none.fl_str_mv |
2021 |
dc.type.eng.fl_str_mv |
Thesis |
dc.type.driver.spa.fl_str_mv |
info:eu-repo/semantics/masterThesis |
dc.type.local.spa.fl_str_mv |
Tesis |
dc.type.redcol.spa.fl_str_mv |
http://purl.org/redcol/resource_type/TM |
dc.identifier.uri.none.fl_str_mv |
http://hdl.handle.net/20.500.12749/13958 |
dc.identifier.instname.spa.fl_str_mv |
instname:Universidad Autónoma de Bucaramanga - UNAB |
dc.identifier.reponame.spa.fl_str_mv |
reponame:Repositorio Institucional UNAB |
dc.identifier.repourl.spa.fl_str_mv |
repourl:https://repository.unab.edu.co |
url |
http://hdl.handle.net/20.500.12749/13958 |
identifier_str_mv |
instname:Universidad Autónoma de Bucaramanga - UNAB reponame:Repositorio Institucional UNAB repourl:https://repository.unab.edu.co |
dc.language.iso.spa.fl_str_mv |
spa |
language |
spa |
dc.relation.references.spa.fl_str_mv |
1. Gijn J, Kerr RS, Rinkel GJ. Subarachnoid haemorrhage. Lancet. 2007;369:306–18. doi: 10.1016/S0140-6736(07)60153-6 2. Cardentey-Pereda AL, Pérez-Falero RA. Hemorragia subaracnoidea. Rev Neurol. 2002;34(10):954–66. 3. Rooij NK, Linn FHH, Van Der Plas JA, Algra A Rinkel GJE. Incidence of subarachnoid haemorrhage: a systematic review with emphasis on region, age, gender and times trends. J Neurol Neurosurg Psychiatry. 2007;78:1365– 72. doi: 10.1136/jnnp.2007.117655 4. Abdul-Ghaffar NU, El Sonbaty MR, EL-DIN Abdul-Baky MS, Maraffie AA, ALSaid AM. Stroke In Kuwait: a three-year prospective study. Neuroepidemiology. 1997;16(1):40–7. doi: 10.1159/000109669 5. Inagawa T, Tokuda Y, Ohbayashi N, Takaya M, Moritake K. Study of aneurysmal subarachnoid hemorrhage in Izumo city, Japan. Stroke. 1995;26(5):761–6. doi: 10.1161/01.STR.26.5.761 6. Lavados PM, Sacks C, Prina L, Escobar A, Tossi C, Araya F, Feuerhake W, Galvez M, Salinas R, Alvarez G. Incidente, 30-day case-fatality rate, and prognosis of stroke in Iquique, Chile: a 2-year community-based prospective study (PISCIS Project) Lancet. 2005;365:2206–15. doi: 10.1016/S01406736(05)66779-7 7. Isaksen J, Egge A, Waterloo K, Romner B, Ingebrigtsen T. Risk factors for aneurysmal subarachnoid haemorrhage: the tromsϕ study. J Neurol Neurosurg Psychiatry. 2002;73:185–7. doi: 10.1136/jnnp.73.2.185 8. Teunissen LL, Rinkel GJ, Algra A, Van Gijn J. Risk factors for subarachnoid hemorrhage: a systematic review. Stroke. 1996;27:544–9. doi: 10.1161/01.STR.27.3.544 9. Kissela BM, Sauerbeck L, Woo D, Khoury J, Carrozzella J, Pancioli A, Jauch E, Moomaw CJ, Shukla R, Gebel J, Fontaine R, Broderick J. Subarachnoid hemorrhage: a preventable disease with a heritable component. Stroke. 2002;33:1321–6. doi: 10.1161/01.STR.0000014773.57733.3E 10. Feigin V, Parag V, Lawes C, Rodgers A, Woodward M, Jamrozik K, Ueshima H. Smoking and elevated blood pressure are the most important risk factors for subarachnoid haemorrhage in the Asia-Pacific region. An overview of 26 cohorts involving 306 620 participants. Stroke. 2005;36:1360–5. doi: 10.1161/01.STR.0000170710.95689.41. 11. Inagawa T. Seasonal variation in the incidence of aneurysmal subarachnoid hemorrhage in hospital and community-based studies. J Neurosurg. 2002;96:497–509. doi: 10.3171/jns.2002.96.3.0497 12. Unemura K, Hirashima Y, Kurimoto M, Kuwayama N, Kubo M, Origasa H, Doshi M, Endo S. Involvement of meteorological factors and sex in the occurrence of subarachnoid hemorrhage in Japan. Neurol Med Chir (Tokio) 2008;48:101–7. doi: 10.2176/nmc.48.101 13. Abe T, Ohde S, Ishimatsu S, Ogata H, Hasegawa T, Nakamura T, Tokuda Y. Effects of meteorological factors on the onset of subarachnoid hemorrhage: A time-series analysis. Journal of Clinical Neuroscience. 2008;15:1005–10. doi: 10.1016/j.jocn.2007.07.081 14. Beseoglu K, Hänggi D, Stummer W, Steiger HJ. Dependence of subarachnoid hemorrhage on climate conditions: A systematic meteorological analysis from the Düsseldorf metropolitan area. Neurosurgery. 2008;62(5):1033–9. doi: 10.1227/01.neu.0000325864.91584.c7. 15. Lavados PM, Díaz V, Jadue L, Olavarría VV, Cárcamo DA, Delgado I. Socioeconomic and Cardiovascular variables explaining regional variations in stroke mortality in Chile: An ecological study. Neuroepidemiology. 2011;37(1):45–51. doi: 10.1159/000328872 16. Berrios X, Jadue L, Zenteno J, Ross M, Rodríguez H. Prevalencia de factores de riesgo de enfermedades crónicas. Estudio en población general de la Región Metropolitana, 1986-1987. Rev Méd Chile. 1990;118:597–604 17. Molyneux AJ, Kerr RSC, Yu L-M, Clarke M, Sneade M, Yarnold JA, et al. International subarachnoid aneurysm trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised comparison of effects on survival, dependency, seizures, rebleeding, subgroups, and aneurysm occlusion. Lancet 2005;366:809–17. http://dx.doi. org/10.1016/S0140-6736(05)67214-5 18. Pierot L, Cognard C, Anxionnat R, Ricolfi F, CLARITY Investigators. Endovascular treatment of ruptured intracranial aneurysms: factors affecting midterm quality anatomic results: analysis in a prospective, multicenter series of patients (CLARITY). AJNR Am J Neuroradiol 2012;33:1475–80. http://dx.doi.org/ 10.3174/ajnr.A3003 19. Pierot L, Spelle L, Vitry F, ATENA Investigators. Immediate clinical outcome of patients harboring unruptured intracranial aneurysms treated by endovascular approach: results of the ATENA study. Stroke 2008;39:2497– 504. http://dx.doi.org/10.1161/ STROKEAHA.107.512756 20. G. J. Hademenos, T.F.Massoud,F. Turjman J.W.Sayre Anatomical and morphological factors correlating with rupture of intracranial aneurysms in patients referred for endovascular treatment.Neuroradiology (1998) 40: 755±760 ” Springer-Verlag 1998. 21. S. Pedraza, J. Méndez-Méndez. Valor pronóstico de la tomografía computarizada en la hemorragia subaracnoidea aneurismática aguda. REV NEUROL 2004;39:359-363] 22. Stephen M Russell 1 , Ke Lin, Sigrid A Hahn, Jafar J Jafar. Smaller cerebral aneurysms producing more extensive subarachnoid hemorrhage following rupture: a radiological investigation and discussion of theoretical determinants.J Neurosurg 2003 Aug;99(2):248-53.doi: 10.3171/jns.2003.99.2.0248. 23. Macdonald RL, Jaja B, Cusimano MD, et al. SAHIT Investigators--on the outcome of some subarachnoid hemorrhage clinical trials. Transl Stroke Res. 2013;4(3):286-296. doi:10.1007/s12975-012-0242-1 24. Jaume A.1, Salle F.1, Spagnuolo E. Tratamiento quirúrgico de aneurismas cerebrales en pacientes en la 8va y 9na década de vida.Rev. Chil. Neurocirugía 43: 111-117, 2017 25. Pierot L, Barbet C, Nguyen HA, et al. Intraoperative Complications of Endovascular Treatment of Intracranial Aneurysms with Coiling or Balloonassisted Coiling in a Prospective Multicenter Cohort of 1088 Participants: Analysis of Recanalization after Endovascular Treatment of Intracranial Aneurysm (ARETA) Study. Radiology. 2020;295(2):381-9. doi: 10.1148/radiol.2020191842 26. Horacio Fontana, Héctor Belziti, Flavio Requejo, Sebastián Buratti, Mario Recchia. La circulación cerebral en condiciones patológicas IV. El aneurisma. Rev. argent. neurocir. v.22 n.1 Ciudad Autónoma de Buenos Aires mar. 2008. 27. Unruptured intracranial aneurysms: natural history, clinical outcome, and risks of surgical and endovascular treatment. New Eng J Med 2003; 362: 103- 10. 28. Weir B, Disney L, Karrison Th. Sizes of ruptured and unruptured aneurysms in relation to their sites and the ages of the patients. J Neurosurg 2002; 96: 64-70 29. Carter BS, Sheth S, Chang E, Sethl M., Ogilvy CS. Epidemiology of size distribution of intracranial bifurcation aneurysms: smaller size of distal aneurysms and increasing size of unruptured aneurysms with age. Neurosurgery 2006; 58: 217-23. 30. Weir B, Amidei C, Kongable G, Findlay,JM, Kassell NF, Kelly J, et al. The aspect ratio (dome/neck) of ruptured and unruptured aneurysms. J Neurosurg 2003; 99: 447-51. 31. Kassell NF, Torner,JC. Size of intracranial aneurysms. Neurosurg 1983; 12: 291-7 32. Suzuki J, Ohara H. Origin and growth of cerebral aneurysms. A clinicopathological study. En: Pia, HW, Zierski, J eds.: Intracranial aneurysms 33. Barrow DL, Reissner A. Natural history of intracranial aneurysms and vascular malformations. Clin Neurosurg 1992; 40: 3-39 34. Wirth FP. Surgical treatment of incidental intracranial aneurysms. Clin Neurosurg 1986; 33: 125-35 35. McCormick WF, Acosta-Rua GJ. The size of intracranial aneurysms. An autopsy study. J Neurosurg 1970; 33: 422-7 36. Morita A y col. The natural course of unruptured cerebral aneurysms varies according to its size, location and shape.NEJM 2012;366:2474-82 37. Orz YI, Hongo K, Tanaka Y, Nagashima H, Osawa M, Kyoshima K, et al. Risks of surgery for patients with unruptured intracranial aneurysms. Surg Neurol 2000; 53: 21-9. 38. Solomon RA, Fink ME, Pile-Spellman J. Surgical management of unruptured intracranials. 39. Miguel Robles et al., “Tratamiento endovascular de aneurismas cerebrales asintomáticos. Análisis de una serie de 118 casos,” Revista Argentina de Neurocirugía, v.23 n.1 Ciudad Autónoma de Buenos Aires ene./mar. 2009 40. Krex D, Schakert HK, Schackert G. Genesis of cerebral aneurysms. An update. Acta Neurochir 2001; 143: 429-44 41. Wilson, L. J. T., Harendran, A.,, Grant, M., Baird, T., Schultz, U. G. R., Muir, K. W., Bone,I. (2002). Improving the assessment of outcomes in stroke: Use of a structured interview to assign grades on the Modified Rankin Scale. Stroke, 33, 22432246 42. Yon Kwon Ihn1, Shang Hun Shin2, Seung Kug Baik3 and In Sup ChoI.Complications of endovascular treatment for intracranial aneurysms: Management and prevention. Interventional Neuroradiology 2018 0(00) 1–9. 43. Kallmes DF, Hanel R, Lopes D, et al. International retrospective study of the pipeline embolization device: A multicenter aneurysm treatment study. AJNR Am J Neuroradiol 2015; 36: 108–115 44. Seibert B, Tummala RP, Chow R, Faridar A, Mousavi SA, Divani AA. Intracranial aneurysms: review of current treatment options and outcomes. Front Neurol. 2011;2:45). 45. 45.Hop JW, Rinkel GJ, Algra A, van Gijn J. Case-fatality rates and functional outcome after subarachnoid hemorrhage: a systematic review. Stroke. 1997;28:660–664). 46. Bender MT, Wendt H, Monarch T, Beaty N, Lin LM, Huang J, Coon A, Tamargo RJ, Colby GP. Small Aneurysms Account for the Majority and Increasing Percentage of Aneurysmal Subarachnoid Hemorrhage: A 25-Year, Single Institution Study. Neurosurgery. 2018 Oct 1;83(4):692-699 47. Ohashi Y, Horikoshi T, Sugita M, Yagishita T, Nukui H. Size of cerebral aneurysms and related factors in patients with subarachnoid hemorrhage. Surg Neurol. 2004 Mar;61(3):239-45; discussion 245-7). 48. Orz Y, Kobayashi S, Osawa M, Tanaka Y. Aneurysm size: a prognostic factor for rupture. Br J Neurosurg. 1997 Apr;11(2):144-9. doi: 10.1080/02688699746500. PMID: 9156002). 49. Molyneux A. International Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised trial. Lancet. 2002;360(9342):1267-1274 50. Turan N, Heider RA, Zaharieva D, Ahmad FU, Barrow DL, Pradilla G. Sex Differences in the Formation of Intracranial Aneurysms and Incidence and Outcome of Subarachnoid Hemorrhage: Review of Experimental and Human Studies. Transl Stroke Res. 2016 Feb;7(1):12-9), 51. abuchi S. Relationship between postmenopausal estrogen deficiency and aneurysmal subarachnoid hemorrhage. Behav Neurol. 2015;2015:720141). 52. Chee, L. C., Siregar, J. A., Ghani, A., Idris, Z., & Rahman Mohd, N. (2018). The Factors Associated with Outcomes in Surgically Managed Ruptured Cerebral Aneurysm. The Malaysian journal of medical sciences : MJMS, 25(1), 32–41. 53. Kim BM, Chung EC, Park SI, et al. Treatment of blood blister-like aneurysm of the internal carotid artery with stent-assisted coil embolization followed by stent-within-a-stent technique: case report. J Neurosurg2007;107:1211–13 54. Hong, Y., Wang, Y. J., Deng, Z., Wu, Q., & Zhang, J. M. (2014). Stent-assisted coiling versus coiling in treatment of intracranial aneurysm: a systematic review and meta-analysis. PloS one, 9(1), e82311 55. Henkes H, Bhogal P, Aguilar Pérez M, Lenz-Habijan T, Bannewitz C, Peters M, Sengstock C, Ganslandt O, Lylyk P, Monstadt H. Anti-thrombogenic coatings for devices in neurointerventional surgery: Case report and review of the literature. Interv Neuroradiol. 2019 Dec;25(6):619-627 56. Walcott, BP, Stapleton, CJ, Choudhri, O, et al. Flow diversion for the treatment of intracranial aneurysms. JAMA Neurol 2016; 73: 1002–1008 57. Rossen, JD, Chalouhi, N, Wassef, SN, et al. Incidence of cerebral ischemic events after discontinuation of clopidogrel in patients with intracranial aneurysms treated with stent-assisted techniques. J Neurosurg 2012; 117: 929–933 58. Cagnazzo, F, di Carlo, DT, Cappucci, M, et al. Acutely ruptured intracranial aneurysms treated with flow-diverter stents: a systematic review and metaanalysis. AJNR Am J Neuroradiol 2018; 39: 1669–1675 59. Piotin M, Blanc R, Spelle L, Mounayer C, Piantino R, et al. (2010) Stentassisted coiling of intracranial aneurysms: clinical and angiographic results in 216 consecutive aneurysms. Stroke; a journal of cerebral circulation 41: 110– 115 60. Bodily KD, Cloft HJ, Lanzino G, Fiorella DJ, White PM, et al. (2011) Stentassisted coiling in acutely ruptured intracranial aneurysms: a qualitative, systematic review of the literature. AJNR Am J Neuroradiol 32: 1232–1236 61. Tahtinen OI, Vanninen RL, Manninen HI, Rautio R, Haapanen A, et al. (2009) Wide-necked intracranial aneurysms: treatment with stent-assisted coil embolization during acute (<72 hours) subarachnoid hemorrhage-experience in 61 consecutive patients. Radiology 253: 199–208 62. Lindvall P, Runnerstam M, Birgander R, Koskinen LO. The Fisher grading correlated to outcome in patients with subarachnoid haemorrhage. Br J Neurosurg. 2009 Apr;23(2):188-92 63. Lobelo N., Navarrete A., Moreno M., Páez C., Avendaño C. Utilidad de la angiografía por sustracción digital 3D en el abordaje endovascular de aneurismas cerebrales. Rev. Colomb. Radiol. 2020; 31(1): 5283-8 64. Duque-Ortega L, Correa-Vélez S, Jiménez-Yepes CM. Dinámica de flujo computacional en aneurismas cerebrales. Rev CES Med 2015;29(2): 239254 65. Juvela S. Aspirin and delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage. J Neurosurg. 1995 Jun;82(6):945-52. doi: 10.3171/jns.1995.82.6.0945. PMID: 7760196 66. Ditz C, Machner B, Schacht H, Neumann A, Schramm P, Tronnier VM, Küchler J. Effects of post-interventional antiplatelet therapy on angiographic vasospasm, delayed cerebral ischemia, and clinical outcome after aneurysmal subarachnoid hemorrhage: a single-center experience. Neurosurg Rev. 2021 Jan 25. doi: 10.1007/s10143-021-01477-6. Epub ahead of print. PMID: 33492514 67. Enriquez-Marulanda A, Salem MM, Ravindran K, Ascanio LC, Maragkos GA, Gomez-Paz S, Alturki AY, Ogilvy CS, Thomas AJ, Moore J. Effect of Premorbid Antiplatelet Medication Use on Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage: A Propensity Score-matched Study. Cureus. 2019 Sep 9;11(9):e5603. doi: 10.7759/cureus.5603. PMID: 31700716; PMCID: PMC6822561. 68. Cagnazzo F, Derraz I, Lefevre PH, Gascou G, Dargazanli C, Riquelme C, Perrini P, di Carlo D, Bonafe A, Costalat V. Antiplatelet Therapy in Patients with Aneurysmal SAH: Impact on Delayed Cerebral Ischemia and Clinical Outcome. A Meta-Analysis. AJNR Am J Neuroradiol. 2019 Jul;40(7):12011206. doi: 10.3174/ajnr.A6086. Epub 2019 Jun 6. PMID: 31171518; PMCID: PMC7048556 69. Brinjikji, W., H.J Cloft, and D.F. Kallmes. ‘Difficult Aneurysms For Endovascular Treatment: Overwide Or Undertall?’. American Journal of Neuroradiology 30.8 (2009): 1513-1517. Web. 3 Oct. 2015 70. Ho, Allen L., Amr Mouminah, and Rose Du. ‘Posterior Cerebral Artery Angle And The Rupture Of Basilar Tip Aneurysms’. PLoS ONE 9.10 (2014): e110946. Web. 2 Oct. 2015. 71. Sekhar, Laligam N. et al. ‘Basilar Tip Aneurysms’. Neurosurgery 72.2 (2013): 284-299. Web. 2 Oct. 2015 |
dc.rights.uri.*.fl_str_mv |
http://creativecommons.org/licenses/by-nc-nd/2.5/co/ |
dc.rights.local.spa.fl_str_mv |
Abierto (Texto Completo) |
dc.rights.accessrights.spa.fl_str_mv |
info:eu-repo/semantics/openAccess |
dc.rights.accessrights.none.fl_str_mv |
http://purl.org/coar/access_right/c_abf2 |
dc.rights.creativecommons.spa.fl_str_mv |
Atribución-NoComercial-SinDerivadas 2.5 Colombia |
rights_invalid_str_mv |
http://creativecommons.org/licenses/by-nc-nd/2.5/co/ Abierto (Texto Completo) http://purl.org/coar/access_right/c_abf2 Atribución-NoComercial-SinDerivadas 2.5 Colombia |
eu_rights_str_mv |
openAccess |
dc.format.mimetype.spa.fl_str_mv |
application/pdf |
dc.coverage.spatial.spa.fl_str_mv |
Bucaramanga (Santander, Colombia) |
dc.coverage.temporal.spa.fl_str_mv |
2014-2019 |
dc.publisher.grantor.spa.fl_str_mv |
Universidad Autónoma de Bucaramanga UNAB |
dc.publisher.faculty.spa.fl_str_mv |
Facultad Ciencias de la Salud |
dc.publisher.program.spa.fl_str_mv |
Especialización en Radiología Intervencionista |
institution |
Universidad Autónoma de Bucaramanga - UNAB |
bitstream.url.fl_str_mv |
https://repository.unab.edu.co/bitstream/20.500.12749/13958/1/2021_Tesis_Aristides_Sotomayor_Rubio.pdf https://repository.unab.edu.co/bitstream/20.500.12749/13958/2/2021_Presentacion_Aristides_Sotomayor_Rubio.pdf https://repository.unab.edu.co/bitstream/20.500.12749/13958/3/2021_Licencia_Aristides_Sotomayor_Rubio.pdf https://repository.unab.edu.co/bitstream/20.500.12749/13958/4/license.txt https://repository.unab.edu.co/bitstream/20.500.12749/13958/5/2021_Tesis_Aristides_Sotomayor_Rubio.pdf.jpg https://repository.unab.edu.co/bitstream/20.500.12749/13958/6/2021_Presentacion_Aristides_Sotomayor_Rubio.pdf.jpg https://repository.unab.edu.co/bitstream/20.500.12749/13958/7/2021_Licencia_Aristides_Sotomayor_Rubio.pdf.jpg |
bitstream.checksum.fl_str_mv |
82f2899e7e67d4c2bf7a2f7af51cde87 da962bdce27f3f55007d0e978064b752 b08240ae1ff39cb6d0ddd4b56c192ec5 8a4605be74aa9ea9d79846c1fba20a33 450bdd5ee6696b80e7e4636da232c011 34a5fb67119ad5d0582b6cbd7b178a11 6c7067fd66f2930acb5d2fd9f02c8f78 |
bitstream.checksumAlgorithm.fl_str_mv |
MD5 MD5 MD5 MD5 MD5 MD5 MD5 |
repository.name.fl_str_mv |
Repositorio Institucional | Universidad Autónoma de Bucaramanga - UNAB |
repository.mail.fl_str_mv |
repositorio@unab.edu.co |
_version_ |
1814277384126332928 |
spelling |
Mantilla García, Daniel EduardoOchoa Vera, Miguel EnriqueSotomayor Rubio, Arístides JesúsMantilla García, Daniel Eduardo [0001437130]Ochoa Vera, Miguel Enrique [0000898465]Mantilla García, Daniel Eduardo [PUqdPK8AAAAJ&hl=es&oi=ao]Mantilla García, Daniel Eduardo [0000-0002-5727-3195]Ochoa Vera, Miguel Enrique [0000-0002-4552-3388]Ochoa Vera, Miguel Enrique [Miguel-Enrique-Ochoa-2186675588]Bucaramanga (Santander, Colombia)2014-20192021-08-23T18:27:56Z2021-08-23T18:27:56Z2021http://hdl.handle.net/20.500.12749/13958instname:Universidad Autónoma de Bucaramanga - UNABreponame:Repositorio Institucional UNABrepourl:https://repository.unab.edu.coLa hemorragia subaracnoidea (HSA) es causada principalmente por la ruptura de aneurismas intracraneales. Se han descrito importantes factores de riesgo como la edad, el sexo, el tabaquismo, la hipertensión (HTA), el tamaño de los aneurismas y la estación del año, entre otros. La mortalidad es de hasta el 50%, hasta un 30% permanecen con secuelas graves y sólo un 30% pueden desarrollar sus actividades de forma independiente. La HSA requiere tratamiento inmediato para evitar nuevos eventos de sangrado. Actualmente no hay estudios de HSA en nuestra región evaluando la relación del tamaño de los aneurismas con los riesgos del tratamiento . Este estudio de cohorte retrospectivo se basa en el análisis de datos secundarios anonimizados, y el objetivo es evaluar la asociación entre el pronóstico y las complicaciones del tratamiento, con el tamaño de los aneurismas intracraneales de los pacientes atendidos con hemorragia subaracnoidea en la clínica FOSCAL en el periodo de enero de 2014 a marzo de 2019. Se realizará una descripción de las variables y análisis bivariado.1 RESUMEN 6 2 INTRODUCCIÓN 7 3 PLANTEAMIENTO DEL PROBLEMA Y JUSTIFICACIÓN 9 4 MARCO TEÓRICO 16 5 ESTADO DEL ARTE 30 6 OBJETIVOS 36 6.1 OBJETIVO GENERAL 36 6.2 OBJETIVOS ESPECÍFICOS : 36 7 METODOLOGÍA PROPUESTA 38 7.1 TIPO DE ESTUDIO 38 7.2 POBLACIÓN DE ESTUDIO 38 7.3 CRITERIOS DE INCLUSIÓN Y EXCLUSIÓN 38 8 PLAN DE ANÁLISIS 40 9 RESULTADOS/PRODUCTOS ESPERADOS Y POTENCIALES BENEFICIARIOS: 41 10 ASPECTOS ÉTICOS 42 11 RESULTADOS 43 11.1 DATOS INICIALES 43 11.2 CARACTERIZACIÓN GENERAL DE LA POBLACIÓN ESTUDIADA 43 11.3 SÍNTOMAS RELACIONADOS AL INGRESO DE LA POBLACIÓN ESTUDIADA 44 11.4 CARACTERÍSTICAS DE LOS PACIENTES CON HSA A SU INGRESO 44 11.5 TIPO DE TRATAMIENTO REQUERIDO 46 11.6 COMPLICACIONES ASOCIADAS 47 11.7 ANÁLISIS BIVARIADO 48 12 DISCUSIÓN 57 13 CONCLUSIONES 62 14 LIMITACIONES Y FORTALEZAS 63 15 BIBLIOGRAFÍA 64 16 ANEXOS 71 16.1 ANEXO 1 : VARIABLES 71EspecializaciónSubarachnoid hemorrhage (SAH) is mainly caused by ruptured intracranial aneurysms. Important risk factors such as age, sex, smoking, hypertension (HT), the size of the aneurysms and the season of the year, among others, have been described. Mortality is up to 50%, up to 30% remain with serious sequelae and only 30% can carry out their activities independently. SAH requires immediate treatment to prevent further bleeding events. Currently, there are no SAH studies in our region evaluating the relationship of the size of the aneurysms with the risks of treatment. This retrospective cohort study is based on the analysis of anonymized secondary data, and the objective is to evaluate the association between prognosis and treatment complications, with the size of intracranial aneurysms in patients treated with subarachnoid hemorrhage at the FOSCAL clinic in the period from January 2014 to March 2019. A description of the variables and bivariate analysis will be made.application/pdfspahttp://creativecommons.org/licenses/by-nc-nd/2.5/co/Abierto (Texto Completo)info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Atribución-NoComercial-SinDerivadas 2.5 ColombiaEvaluación del pronóstico y complicaciones del tratamiento, según el tamaño de los aneurismas intracraneales de los pacientes que debutan con hemorragia subaracnoidea en la Clínica Foscal en el periodo de enero de 2014 a marzo de 2019Evaluation of the prognosis and complications of the treatment, according to the size of the intracranial aneurysms of the patients presenting with subarachnoid hemorrhage at the Foscal Clinic in the period from January 2014 to March 2019Thesisinfo:eu-repo/semantics/masterThesisTesishttp://purl.org/redcol/resource_type/TMEspecialista en Radiología IntervencionistaUniversidad Autónoma de Bucaramanga UNABFacultad Ciencias de la SaludEspecialización en Radiología IntervencionistaMedical sciencesHealth sciencesSubarachnoid hemorrhageHead traumaIntracranial hemorrhageAneurysmsCerebrovascular disordersCiencias médicasHemorragia intracranealAneurismasTrastornos cerebrovascularesCiencias de la saludHemorragia subaracnoideaTraumatismo craneoencefálico1. Gijn J, Kerr RS, Rinkel GJ. Subarachnoid haemorrhage. Lancet. 2007;369:306–18. doi: 10.1016/S0140-6736(07)60153-62. Cardentey-Pereda AL, Pérez-Falero RA. Hemorragia subaracnoidea. Rev Neurol. 2002;34(10):954–66.3. Rooij NK, Linn FHH, Van Der Plas JA, Algra A Rinkel GJE. Incidence of subarachnoid haemorrhage: a systematic review with emphasis on region, age, gender and times trends. J Neurol Neurosurg Psychiatry. 2007;78:1365– 72. doi: 10.1136/jnnp.2007.1176554. Abdul-Ghaffar NU, El Sonbaty MR, EL-DIN Abdul-Baky MS, Maraffie AA, ALSaid AM. Stroke In Kuwait: a three-year prospective study. Neuroepidemiology. 1997;16(1):40–7. doi: 10.1159/0001096695. Inagawa T, Tokuda Y, Ohbayashi N, Takaya M, Moritake K. Study of aneurysmal subarachnoid hemorrhage in Izumo city, Japan. Stroke. 1995;26(5):761–6. doi: 10.1161/01.STR.26.5.7616. Lavados PM, Sacks C, Prina L, Escobar A, Tossi C, Araya F, Feuerhake W, Galvez M, Salinas R, Alvarez G. Incidente, 30-day case-fatality rate, and prognosis of stroke in Iquique, Chile: a 2-year community-based prospective study (PISCIS Project) Lancet. 2005;365:2206–15. doi: 10.1016/S01406736(05)66779-77. Isaksen J, Egge A, Waterloo K, Romner B, Ingebrigtsen T. Risk factors for aneurysmal subarachnoid haemorrhage: the tromsϕ study. J Neurol Neurosurg Psychiatry. 2002;73:185–7. doi: 10.1136/jnnp.73.2.1858. Teunissen LL, Rinkel GJ, Algra A, Van Gijn J. Risk factors for subarachnoid hemorrhage: a systematic review. Stroke. 1996;27:544–9. doi: 10.1161/01.STR.27.3.5449. Kissela BM, Sauerbeck L, Woo D, Khoury J, Carrozzella J, Pancioli A, Jauch E, Moomaw CJ, Shukla R, Gebel J, Fontaine R, Broderick J. Subarachnoid hemorrhage: a preventable disease with a heritable component. Stroke. 2002;33:1321–6. doi: 10.1161/01.STR.0000014773.57733.3E10. Feigin V, Parag V, Lawes C, Rodgers A, Woodward M, Jamrozik K, Ueshima H. Smoking and elevated blood pressure are the most important risk factors for subarachnoid haemorrhage in the Asia-Pacific region. An overview of 26 cohorts involving 306 620 participants. Stroke. 2005;36:1360–5. doi: 10.1161/01.STR.0000170710.95689.41.11. Inagawa T. Seasonal variation in the incidence of aneurysmal subarachnoid hemorrhage in hospital and community-based studies. J Neurosurg. 2002;96:497–509. doi: 10.3171/jns.2002.96.3.049712. Unemura K, Hirashima Y, Kurimoto M, Kuwayama N, Kubo M, Origasa H, Doshi M, Endo S. Involvement of meteorological factors and sex in the occurrence of subarachnoid hemorrhage in Japan. Neurol Med Chir (Tokio) 2008;48:101–7. doi: 10.2176/nmc.48.10113. Abe T, Ohde S, Ishimatsu S, Ogata H, Hasegawa T, Nakamura T, Tokuda Y. Effects of meteorological factors on the onset of subarachnoid hemorrhage: A time-series analysis. Journal of Clinical Neuroscience. 2008;15:1005–10. doi: 10.1016/j.jocn.2007.07.08114. Beseoglu K, Hänggi D, Stummer W, Steiger HJ. Dependence of subarachnoid hemorrhage on climate conditions: A systematic meteorological analysis from the Düsseldorf metropolitan area. Neurosurgery. 2008;62(5):1033–9. doi: 10.1227/01.neu.0000325864.91584.c7.15. Lavados PM, Díaz V, Jadue L, Olavarría VV, Cárcamo DA, Delgado I. Socioeconomic and Cardiovascular variables explaining regional variations in stroke mortality in Chile: An ecological study. Neuroepidemiology. 2011;37(1):45–51. doi: 10.1159/00032887216. Berrios X, Jadue L, Zenteno J, Ross M, Rodríguez H. Prevalencia de factores de riesgo de enfermedades crónicas. Estudio en población general de la Región Metropolitana, 1986-1987. Rev Méd Chile. 1990;118:597–60417. Molyneux AJ, Kerr RSC, Yu L-M, Clarke M, Sneade M, Yarnold JA, et al. International subarachnoid aneurysm trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised comparison of effects on survival, dependency, seizures, rebleeding, subgroups, and aneurysm occlusion. Lancet 2005;366:809–17. http://dx.doi. org/10.1016/S0140-6736(05)67214-518. Pierot L, Cognard C, Anxionnat R, Ricolfi F, CLARITY Investigators. Endovascular treatment of ruptured intracranial aneurysms: factors affecting midterm quality anatomic results: analysis in a prospective, multicenter series of patients (CLARITY). AJNR Am J Neuroradiol 2012;33:1475–80. http://dx.doi.org/ 10.3174/ajnr.A300319. Pierot L, Spelle L, Vitry F, ATENA Investigators. Immediate clinical outcome of patients harboring unruptured intracranial aneurysms treated by endovascular approach: results of the ATENA study. Stroke 2008;39:2497– 504. http://dx.doi.org/10.1161/ STROKEAHA.107.51275620. G. J. Hademenos, T.F.Massoud,F. Turjman J.W.Sayre Anatomical and morphological factors correlating with rupture of intracranial aneurysms in patients referred for endovascular treatment.Neuroradiology (1998) 40: 755±760 ” Springer-Verlag 1998.21. S. Pedraza, J. Méndez-Méndez. Valor pronóstico de la tomografía computarizada en la hemorragia subaracnoidea aneurismática aguda. REV NEUROL 2004;39:359-363]22. Stephen M Russell 1 , Ke Lin, Sigrid A Hahn, Jafar J Jafar. Smaller cerebral aneurysms producing more extensive subarachnoid hemorrhage following rupture: a radiological investigation and discussion of theoretical determinants.J Neurosurg 2003 Aug;99(2):248-53.doi: 10.3171/jns.2003.99.2.0248.23. Macdonald RL, Jaja B, Cusimano MD, et al. SAHIT Investigators--on the outcome of some subarachnoid hemorrhage clinical trials. Transl Stroke Res. 2013;4(3):286-296. doi:10.1007/s12975-012-0242-124. Jaume A.1, Salle F.1, Spagnuolo E. Tratamiento quirúrgico de aneurismas cerebrales en pacientes en la 8va y 9na década de vida.Rev. Chil. Neurocirugía 43: 111-117, 201725. Pierot L, Barbet C, Nguyen HA, et al. Intraoperative Complications of Endovascular Treatment of Intracranial Aneurysms with Coiling or Balloonassisted Coiling in a Prospective Multicenter Cohort of 1088 Participants: Analysis of Recanalization after Endovascular Treatment of Intracranial Aneurysm (ARETA) Study. Radiology. 2020;295(2):381-9. doi: 10.1148/radiol.202019184226. Horacio Fontana, Héctor Belziti, Flavio Requejo, Sebastián Buratti, Mario Recchia. La circulación cerebral en condiciones patológicas IV. El aneurisma. Rev. argent. neurocir. v.22 n.1 Ciudad Autónoma de Buenos Aires mar. 2008.27. Unruptured intracranial aneurysms: natural history, clinical outcome, and risks of surgical and endovascular treatment. New Eng J Med 2003; 362: 103- 10.28. Weir B, Disney L, Karrison Th. Sizes of ruptured and unruptured aneurysms in relation to their sites and the ages of the patients. J Neurosurg 2002; 96: 64-7029. Carter BS, Sheth S, Chang E, Sethl M., Ogilvy CS. Epidemiology of size distribution of intracranial bifurcation aneurysms: smaller size of distal aneurysms and increasing size of unruptured aneurysms with age. Neurosurgery 2006; 58: 217-23.30. Weir B, Amidei C, Kongable G, Findlay,JM, Kassell NF, Kelly J, et al. The aspect ratio (dome/neck) of ruptured and unruptured aneurysms. J Neurosurg 2003; 99: 447-51.31. Kassell NF, Torner,JC. Size of intracranial aneurysms. Neurosurg 1983; 12: 291-732. Suzuki J, Ohara H. Origin and growth of cerebral aneurysms. A clinicopathological study. En: Pia, HW, Zierski, J eds.: Intracranial aneurysms33. Barrow DL, Reissner A. Natural history of intracranial aneurysms and vascular malformations. Clin Neurosurg 1992; 40: 3-3934. Wirth FP. Surgical treatment of incidental intracranial aneurysms. Clin Neurosurg 1986; 33: 125-3535. McCormick WF, Acosta-Rua GJ. The size of intracranial aneurysms. An autopsy study. J Neurosurg 1970; 33: 422-736. Morita A y col. The natural course of unruptured cerebral aneurysms varies according to its size, location and shape.NEJM 2012;366:2474-8237. Orz YI, Hongo K, Tanaka Y, Nagashima H, Osawa M, Kyoshima K, et al. Risks of surgery for patients with unruptured intracranial aneurysms. Surg Neurol 2000; 53: 21-9.38. Solomon RA, Fink ME, Pile-Spellman J. Surgical management of unruptured intracranials.39. Miguel Robles et al., “Tratamiento endovascular de aneurismas cerebrales asintomáticos. Análisis de una serie de 118 casos,” Revista Argentina de Neurocirugía, v.23 n.1 Ciudad Autónoma de Buenos Aires ene./mar. 200940. Krex D, Schakert HK, Schackert G. Genesis of cerebral aneurysms. An update. Acta Neurochir 2001; 143: 429-4441. Wilson, L. J. T., Harendran, A.,, Grant, M., Baird, T., Schultz, U. G. R., Muir, K. W., Bone,I. (2002). Improving the assessment of outcomes in stroke: Use of a structured interview to assign grades on the Modified Rankin Scale. Stroke, 33, 2243224642. Yon Kwon Ihn1, Shang Hun Shin2, Seung Kug Baik3 and In Sup ChoI.Complications of endovascular treatment for intracranial aneurysms: Management and prevention. Interventional Neuroradiology 2018 0(00) 1–9.43. Kallmes DF, Hanel R, Lopes D, et al. International retrospective study of the pipeline embolization device: A multicenter aneurysm treatment study. AJNR Am J Neuroradiol 2015; 36: 108–11544. Seibert B, Tummala RP, Chow R, Faridar A, Mousavi SA, Divani AA. Intracranial aneurysms: review of current treatment options and outcomes. Front Neurol. 2011;2:45).45. 45.Hop JW, Rinkel GJ, Algra A, van Gijn J. Case-fatality rates and functional outcome after subarachnoid hemorrhage: a systematic review. Stroke. 1997;28:660–664).46. Bender MT, Wendt H, Monarch T, Beaty N, Lin LM, Huang J, Coon A, Tamargo RJ, Colby GP. Small Aneurysms Account for the Majority and Increasing Percentage of Aneurysmal Subarachnoid Hemorrhage: A 25-Year, Single Institution Study. Neurosurgery. 2018 Oct 1;83(4):692-69947. Ohashi Y, Horikoshi T, Sugita M, Yagishita T, Nukui H. Size of cerebral aneurysms and related factors in patients with subarachnoid hemorrhage. Surg Neurol. 2004 Mar;61(3):239-45; discussion 245-7).48. Orz Y, Kobayashi S, Osawa M, Tanaka Y. Aneurysm size: a prognostic factor for rupture. Br J Neurosurg. 1997 Apr;11(2):144-9. doi: 10.1080/02688699746500. PMID: 9156002).49. Molyneux A. International Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised trial. Lancet. 2002;360(9342):1267-127450. Turan N, Heider RA, Zaharieva D, Ahmad FU, Barrow DL, Pradilla G. Sex Differences in the Formation of Intracranial Aneurysms and Incidence and Outcome of Subarachnoid Hemorrhage: Review of Experimental and Human Studies. Transl Stroke Res. 2016 Feb;7(1):12-9),51. abuchi S. Relationship between postmenopausal estrogen deficiency and aneurysmal subarachnoid hemorrhage. Behav Neurol. 2015;2015:720141).52. Chee, L. C., Siregar, J. A., Ghani, A., Idris, Z., & Rahman Mohd, N. (2018). The Factors Associated with Outcomes in Surgically Managed Ruptured Cerebral Aneurysm. The Malaysian journal of medical sciences : MJMS, 25(1), 32–41.53. Kim BM, Chung EC, Park SI, et al. Treatment of blood blister-like aneurysm of the internal carotid artery with stent-assisted coil embolization followed by stent-within-a-stent technique: case report. J Neurosurg2007;107:1211–1354. Hong, Y., Wang, Y. J., Deng, Z., Wu, Q., & Zhang, J. M. (2014). Stent-assisted coiling versus coiling in treatment of intracranial aneurysm: a systematic review and meta-analysis. PloS one, 9(1), e8231155. Henkes H, Bhogal P, Aguilar Pérez M, Lenz-Habijan T, Bannewitz C, Peters M, Sengstock C, Ganslandt O, Lylyk P, Monstadt H. Anti-thrombogenic coatings for devices in neurointerventional surgery: Case report and review of the literature. Interv Neuroradiol. 2019 Dec;25(6):619-62756. Walcott, BP, Stapleton, CJ, Choudhri, O, et al. Flow diversion for the treatment of intracranial aneurysms. JAMA Neurol 2016; 73: 1002–100857. Rossen, JD, Chalouhi, N, Wassef, SN, et al. Incidence of cerebral ischemic events after discontinuation of clopidogrel in patients with intracranial aneurysms treated with stent-assisted techniques. J Neurosurg 2012; 117: 929–93358. Cagnazzo, F, di Carlo, DT, Cappucci, M, et al. Acutely ruptured intracranial aneurysms treated with flow-diverter stents: a systematic review and metaanalysis. AJNR Am J Neuroradiol 2018; 39: 1669–167559. Piotin M, Blanc R, Spelle L, Mounayer C, Piantino R, et al. (2010) Stentassisted coiling of intracranial aneurysms: clinical and angiographic results in 216 consecutive aneurysms. Stroke; a journal of cerebral circulation 41: 110– 11560. Bodily KD, Cloft HJ, Lanzino G, Fiorella DJ, White PM, et al. (2011) Stentassisted coiling in acutely ruptured intracranial aneurysms: a qualitative, systematic review of the literature. AJNR Am J Neuroradiol 32: 1232–123661. Tahtinen OI, Vanninen RL, Manninen HI, Rautio R, Haapanen A, et al. (2009) Wide-necked intracranial aneurysms: treatment with stent-assisted coil embolization during acute (<72 hours) subarachnoid hemorrhage-experience in 61 consecutive patients. Radiology 253: 199–20862. Lindvall P, Runnerstam M, Birgander R, Koskinen LO. The Fisher grading correlated to outcome in patients with subarachnoid haemorrhage. Br J Neurosurg. 2009 Apr;23(2):188-9263. Lobelo N., Navarrete A., Moreno M., Páez C., Avendaño C. Utilidad de la angiografía por sustracción digital 3D en el abordaje endovascular de aneurismas cerebrales. Rev. Colomb. Radiol. 2020; 31(1): 5283-864. Duque-Ortega L, Correa-Vélez S, Jiménez-Yepes CM. Dinámica de flujo computacional en aneurismas cerebrales. Rev CES Med 2015;29(2): 23925465. Juvela S. Aspirin and delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage. J Neurosurg. 1995 Jun;82(6):945-52. doi: 10.3171/jns.1995.82.6.0945. PMID: 776019666. Ditz C, Machner B, Schacht H, Neumann A, Schramm P, Tronnier VM, Küchler J. Effects of post-interventional antiplatelet therapy on angiographic vasospasm, delayed cerebral ischemia, and clinical outcome after aneurysmal subarachnoid hemorrhage: a single-center experience. Neurosurg Rev. 2021 Jan 25. doi: 10.1007/s10143-021-01477-6. Epub ahead of print. PMID: 3349251467. Enriquez-Marulanda A, Salem MM, Ravindran K, Ascanio LC, Maragkos GA, Gomez-Paz S, Alturki AY, Ogilvy CS, Thomas AJ, Moore J. Effect of Premorbid Antiplatelet Medication Use on Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage: A Propensity Score-matched Study. Cureus. 2019 Sep 9;11(9):e5603. doi: 10.7759/cureus.5603. PMID: 31700716; PMCID: PMC6822561.68. Cagnazzo F, Derraz I, Lefevre PH, Gascou G, Dargazanli C, Riquelme C, Perrini P, di Carlo D, Bonafe A, Costalat V. Antiplatelet Therapy in Patients with Aneurysmal SAH: Impact on Delayed Cerebral Ischemia and Clinical Outcome. A Meta-Analysis. AJNR Am J Neuroradiol. 2019 Jul;40(7):12011206. doi: 10.3174/ajnr.A6086. Epub 2019 Jun 6. PMID: 31171518; PMCID: PMC704855669. Brinjikji, W., H.J Cloft, and D.F. Kallmes. ‘Difficult Aneurysms For Endovascular Treatment: Overwide Or Undertall?’. American Journal of Neuroradiology 30.8 (2009): 1513-1517. Web. 3 Oct. 201570. Ho, Allen L., Amr Mouminah, and Rose Du. ‘Posterior Cerebral Artery Angle And The Rupture Of Basilar Tip Aneurysms’. PLoS ONE 9.10 (2014): e110946. Web. 2 Oct. 2015.71. Sekhar, Laligam N. et al. ‘Basilar Tip Aneurysms’. Neurosurgery 72.2 (2013): 284-299. Web. 2 Oct. 2015ORIGINAL2021_Tesis_Aristides_Sotomayor_Rubio.pdf2021_Tesis_Aristides_Sotomayor_Rubio.pdfTesisapplication/pdf1317880https://repository.unab.edu.co/bitstream/20.500.12749/13958/1/2021_Tesis_Aristides_Sotomayor_Rubio.pdf82f2899e7e67d4c2bf7a2f7af51cde87MD51open access2021_Presentacion_Aristides_Sotomayor_Rubio.pdf2021_Presentacion_Aristides_Sotomayor_Rubio.pdfPresentaciónapplication/pdf1305169https://repository.unab.edu.co/bitstream/20.500.12749/13958/2/2021_Presentacion_Aristides_Sotomayor_Rubio.pdfda962bdce27f3f55007d0e978064b752MD52open access2021_Licencia_Aristides_Sotomayor_Rubio.pdf2021_Licencia_Aristides_Sotomayor_Rubio.pdfLicenciaapplication/pdf382317https://repository.unab.edu.co/bitstream/20.500.12749/13958/3/2021_Licencia_Aristides_Sotomayor_Rubio.pdfb08240ae1ff39cb6d0ddd4b56c192ec5MD53metadata only accessLICENSElicense.txtlicense.txttext/plain; charset=utf-81748https://repository.unab.edu.co/bitstream/20.500.12749/13958/4/license.txt8a4605be74aa9ea9d79846c1fba20a33MD54open accessTHUMBNAIL2021_Tesis_Aristides_Sotomayor_Rubio.pdf.jpg2021_Tesis_Aristides_Sotomayor_Rubio.pdf.jpgIM Thumbnailimage/jpeg6033https://repository.unab.edu.co/bitstream/20.500.12749/13958/5/2021_Tesis_Aristides_Sotomayor_Rubio.pdf.jpg450bdd5ee6696b80e7e4636da232c011MD55open access2021_Presentacion_Aristides_Sotomayor_Rubio.pdf.jpg2021_Presentacion_Aristides_Sotomayor_Rubio.pdf.jpgIM Thumbnailimage/jpeg7750https://repository.unab.edu.co/bitstream/20.500.12749/13958/6/2021_Presentacion_Aristides_Sotomayor_Rubio.pdf.jpg34a5fb67119ad5d0582b6cbd7b178a11MD56open access2021_Licencia_Aristides_Sotomayor_Rubio.pdf.jpg2021_Licencia_Aristides_Sotomayor_Rubio.pdf.jpgIM Thumbnailimage/jpeg10474https://repository.unab.edu.co/bitstream/20.500.12749/13958/7/2021_Licencia_Aristides_Sotomayor_Rubio.pdf.jpg6c7067fd66f2930acb5d2fd9f02c8f78MD57open access20.500.12749/13958oai:repository.unab.edu.co:20.500.12749/139582021-08-23 18:01:06.428open accessRepositorio Institucional | Universidad Autónoma de Bucaramanga - UNABrepositorio@unab.edu.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 |