Any clinical events during/immediately after or in the follow-up period
Adverse Events | No. of Patients | Permanent Morbidity/Mortality |
---|---|---|
Due to medication | ||
Intracranial hemorrhage | 2 | 1 |
Aplastic anemiaa | 1 | No |
Hematuria (requiring change in medical treatment) | 1 | No |
GI bleeding (including the FU period) | 2 | No |
Associated with intervention | ||
Deep vein thrombosis | 1 | No |
Retroperitoneal hematomab | 3 | No |
Associated with aneurysm treatment | ||
Due to mass effectc | 4 | 1 |
SAH (aneurysm rupture) | 1 | Nod |
In relation to PED | ||
Perioperative thromboembolic event | 4 | 1) Mortality (jailed PCA occlusion) |
3) Symptoms resolved totallye | ||
In-stent stenosisf | 8 | No |
Mild | 5 No intervention | |
Severe | 3 PTAs performedg | |
Ischemic event in the FU period | 1e | |
Total | 27 (14.1%)e | 2 (1%)/1 (0.5%) |
Note:—FU indicates follow-up; GI, gastrointestinal; PTA, percutaneous transarterial angioplasty.
↵a Occurred in the patient who had resistance to clopidogrel and was on ticlopidine.
↵b Included in the group of complications that are attributed to intervention, but antithrombocytic medication may also have contributed.
↵c Any new symptom or increase in the findings are taken into consideration; 3 had deteriorating vision loss, of whom 2 also had visual field defects. In 2 patients, the symptoms regressed to their preoperative degree in the follow-up and caused permanent additional morbidity in 1. The remaining patient had symptoms due to mass effect on the brain stem, aggravated after the treatment, but resolved in 4 weeks' time.
↵d This patient had subarachnoid hemorrhage 4 months after the treatment; imaging still showed filling of the aneurysm despite significant decrease. Initially she had had hemiparesis, but this resolved totally.
↵e One patient had an ischemic attack in the postoperative 4 months after he discontinued clopidogrel without consulting his doctor. The patient was medicated with IV heparin, and clopidogrel was loaded again. The symptom of monoparesis resolved totally. The same patient woke up from the general anesthesia with monoparesis but immediately became asymptomatic after volume loading and raising the blood pressure.
↵f Mild refers to any intimal thickening causing stenosis <50%. Severe refers to stenosis ≥50%.
↵g In 2 patients, stenosis was discovered in the control angiography but PTA was performed because the stenosis was considered significant (>70%). The remaining patient had attacks of dysphasia which resolved after PTA, with no permanent morbidity.