Treatment of aneurysmal subarachnoid hemorrhage and unruptured intracranial aneurysms by neurosurgeons in Colombia: A survey

Abstract

Background:Trends in management of aneurysmal subarachnoid hemorrhage and unruptured intracranial aneurysms among neurosurgeons is very variable and had not been previously described in any Latin American country. This study was conducted to determine the preferences of Colombian neurosurgeons in pharmacologic, surgical, and endovascular management of patients with aneurysmal subarachnoid hemorrhage and unruptured intracranial aneurysms.Methods:A survey-based descriptive study was performed in a sample of members from the Colombian Association of Neurosurgery. Questions about pharmacologic, surgical, and endovascular management of aneurysmal subarachnoid hemorrhage and unruptured intracranial aneurysm were carried out. We calculated the mean and the standard deviation of the results obtained from the continuous variables. The results of the categorical variables are presented as percentages.Results:The preference of medication with poor clinical evidence, such as magnesium sulfate, aspirin, statins, and anti-fibrinolytics was lower than 10%. The use of intravenous nimodipine and systemic glucocorticoids was as high as 31%. The availability of endovascular therapy was 69%. The indication for treatment of patients with unruptured intracranial aneurysms that required intervention was less than 13.8%. In patients with ruptured or unruptured intracranial aneurysms, coiling was the preferred method for exclusion.Conclusions:Reported compliance of evidence-based clinical guidelines was similar to that described in developed countries, and even better. However, there is little agreement in treating patients with unruptured intracranial aneurysms. For other issues, the conducts reported by Colombian neurosurgeons are in accordance with the current guidelines.

Caracterización de los pacientes con tratamiento endovascular de aneurismas disecantes de circulación cerebral posterior en Cartagena de indias

“…Estas técnicas se han logrado implementar en Cartagena de Indias con un importante número de pacientes; sin embargo, aún no existe una descripción publicada de la efectividad de estas intervenciones. Cabe anotar que la disponibilidad de los servicios de terapia endovascular en Colombia son del 69%, ligeramente inferior al de los países de Europa y América del Norte cuyo porcentaje es del 83% (16).…”

Trends in the mortality of non-traumatic subarachnoid hemorrhage in Colombia: a 10-year analysis of a nationwide registry

“…by the percentage of overall SAH-related mortality, which increased by 18% over the study period. On the other hand, this trend in the mortality rate may reflect the quality of care offered to patients with SAH and the increased availability of diagnostic neuroimaging 17 . In people over 70 years old mortality rates have increased significantly, which may be the result of poor performance status and comorbidities.…”