Abstract：
This study aimed to assess the outcomes of outpatient day-care management of unruptured intracranial aneurysm (UIA), and to present the risks associated with different management strategies by comparing the outcomes and adverse events between outpatient day-care management and management with longer admission periods.
This retrospective cohort study used prospectively registered data and was approved by a local institutional review board. We enrolled 956 UIAs from 811 consecutive patients (mean age ± standard deviation, 57 ± 10.7 years; male:female = 247:564) from 2017 to 2020. We compared the outcomes after embolization among the different admission-length groups (1, 2, and ≥ 3 days). The outcomes included pre- and post-modified Rankin Scale (mRS) scores and rates of adverse events, cure, recurrence, and reprocedure. Events were defined as any cerebrovascular problems, including minor and major stroke, death, or hemorrhage.
The mean admission period was 2 days, and 175 patients (191 aneurysms), 551 patients (664 aneurysms), and 85 patients (101 aneurysms) were discharged on the day of the procedure, day 2, and day 3 or later, respectively. During the mean 17-month follow-up period (range 6-53 months; 2757 patient years), no change in post-mRS was observed compared to pre-mRS in 99.6% of patients. Cure was achieved in 95.6% patients; minimal recurrence that did not require re-procedure occurred in 3.5% patients, and re-procedure was required in 2.3% (22 of 956) patients due to progressive enlargement of the recurrent sac during follow up (mean 17 months, range, 6-53 months). There were eight adverse events (0.8%), including five cerebrovascular (two major stroke, two minor strokes and one transient ischemic stroke), and three non-cerebrovascular events. Statistical comparison between groups with different admission lengths (1, 2, and ≥ 3 days) revealed no difference in the outcomes.
This study revealed no difference in outcomes and adverse events according to the admission period, and suggested that UIA could be managed by outpatient day-care embolization.
This retrospective cohort study used prospectively registered data and was approved by a local institutional review board. We enrolled 956 UIAs from 811 consecutive patients (mean age ± standard deviation, 57 ± 10.7 years; male:female = 247:564) from 2017 to 2020. We compared the outcomes after embolization among the different admission-length groups (1, 2, and ≥ 3 days). The outcomes included pre- and post-modified Rankin Scale (mRS) scores and rates of adverse events, cure, recurrence, and reprocedure. Events were defined as any cerebrovascular problems, including minor and major stroke, death, or hemorrhage.
The mean admission period was 2 days, and 175 patients (191 aneurysms), 551 patients (664 aneurysms), and 85 patients (101 aneurysms) were discharged on the day of the procedure, day 2, and day 3 or later, respectively. During the mean 17-month follow-up period (range 6-53 months; 2757 patient years), no change in post-mRS was observed compared to pre-mRS in 99.6% of patients. Cure was achieved in 95.6% patients; minimal recurrence that did not require re-procedure occurred in 3.5% patients, and re-procedure was required in 2.3% (22 of 956) patients due to progressive enlargement of the recurrent sac during follow up (mean 17 months, range, 6-53 months). There were eight adverse events (0.8%), including five cerebrovascular (two major stroke, two minor strokes and one transient ischemic stroke), and three non-cerebrovascular events. Statistical comparison between groups with different admission lengths (1, 2, and ≥ 3 days) revealed no difference in the outcomes.
This study revealed no difference in outcomes and adverse events according to the admission period, and suggested that UIA could be managed by outpatient day-care embolization.
摘要：
本研究旨在评估未破裂颅内动脉瘤（UIA）的门诊日托管理的结果。并通过比较门诊日托管理和住院时间较长的管理的结局和不良事件，提出与不同管理策略相关的风险。
这项回顾性队列研究使用了前瞻性登记的数据，并得到了当地机构审查委员会的批准。我们从811名连续患者中招募了956名UIA(平均年龄±标准差，57±10.7岁；男性：女性=247：564），从2017年到2020年。我们比较了不同入院时间组（1、2和≥3天）的栓塞后的结果。结果包括改良Rankin量表（mRS）评分和不良事件发生率，治愈,复发,和重新程序。事件被定义为任何脑血管问题，包括轻微和严重中风，死亡,或出血。
平均入院时间为2天,和175名患者（191个动脉瘤），551例患者（664个动脉瘤），手术当天有85名患者（101个动脉瘤）出院，第2天，第3天或更晚，分别。在平均17个月的随访期间（范围6-53个月；2757个患者年），在99.6%的患者中,与mRS前相比,未观察到mRS后的变化.95.6％的患者达到治愈;3.5％的患者发生不需要重新手术的最小复发，并且由于随访期间复发性囊的进行性扩大，需要重新手术的患者占2.3％（956人中的22人）（平均17个月，范围,6-53个月）。有8个不良事件（0.8％），包括五个脑血管（两个主要中风，两次轻微中风和一次短暂性缺血性中风)，和三个非脑血管事件。不同入院时间（1、2和≥3天）的组之间的统计比较显示结果无差异。
这项研究显示，根据入院时期，结局和不良事件没有差异。并建议可以通过门诊日托栓塞来管理UIA。
这项回顾性队列研究使用了前瞻性登记的数据，并得到了当地机构审查委员会的批准。我们从811名连续患者中招募了956名UIA(平均年龄±标准差，57±10.7岁；男性：女性=247：564），从2017年到2020年。我们比较了不同入院时间组（1、2和≥3天）的栓塞后的结果。结果包括改良Rankin量表（mRS）评分和不良事件发生率，治愈,复发,和重新程序。事件被定义为任何脑血管问题，包括轻微和严重中风，死亡,或出血。
平均入院时间为2天,和175名患者（191个动脉瘤），551例患者（664个动脉瘤），手术当天有85名患者（101个动脉瘤）出院，第2天，第3天或更晚，分别。在平均17个月的随访期间（范围6-53个月；2757个患者年），在99.6%的患者中,与mRS前相比,未观察到mRS后的变化.95.6％的患者达到治愈;3.5％的患者发生不需要重新手术的最小复发，并且由于随访期间复发性囊的进行性扩大，需要重新手术的患者占2.3％（956人中的22人）（平均17个月，范围,6-53个月）。有8个不良事件（0.8％），包括五个脑血管（两个主要中风，两次轻微中风和一次短暂性缺血性中风)，和三个非脑血管事件。不同入院时间（1、2和≥3天）的组之间的统计比较显示结果无差异。
这项研究显示，根据入院时期，结局和不良事件没有差异。并建议可以通过门诊日托栓塞来管理UIA。
