Endovascular Management Following aSAH

Treatment of acute aSAH consists of occluding the aneurysm to prevent rebleed, attempting to prevent vasospasm, and maintaining blood flow to the brain through vessels in vasospasm. Endovascular treatment has been shown to be as safe as, or safer than, surgical clipping for patients with aSAH. A comparison of surgical clipping and endovascular treatment in 109 patients with acute aSAH found comparable survival rates, recovery rates, and neuropsychologic test scores among recovered patients from both groups and a statistically significant increase in superficial brain retraction injury and ischemic lesion among surgical patients (10). Another study demonstrated endovascular coiling of aSAH to cause less structural damage than surgery, but cognitive outcome was primarily determined by resulting complications (11).

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