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  • Presence of Obstructive Sleep Apnea Worsens the Prognosis of Intracranial Aneurysms

    Final Number:
    1038

    Authors:
    Shyamal C Bir MD PhD; Alireza Minagar MD; Anil Nanda MD FACS; Oleg Chernyshev; Hai Sun MD PhD

    Study Design:
    Other

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2016 Annual Meeting

    Introduction: Obstructive sleep apnea (OSA) is associated with progression abdominal aortic aneurysms. However, role of OSA in progression and outcome of treatment in intracranial aneurysm is unknown. We have investigated the role of OSA in progression and outcome of treatment in intracranial aneurysm

    Methods: Patient and aneurysm characteristics and treatment outcomes of patients treated from 2010 through 2015 were analyzed. Association of OSA and outcome of treatment were determined by regression analysis

    Results: Among total 283 patients, 12 (4%) patients had OSA. One hundred and twenty patients (42.4%) underwent surgical clipping, 145 patients (51.2%) were undergone endovascular coiling and 18 (6.4%) were observed. Angiographically, patients with OSA (22%) had comparatively higher number of residual aneurysms than patient without OSA (14%). Vasospasm after initial treatment was significantly higher in OSA (25%) group compared to without OSA (8%) group (p=0.004). The mean MRS score was 2 and 1.4 in OSA and without OSA groups, respectively. On regression analysis, patients without OSA (p=0.03), non-smoker (p=0.02) and coiling (p=0.02) were identified as predictors of better outcome. African Americans (0.005), with OSA (p=0.049) and ruptured aneurysms (p<0.001) had significantly higher number of vasospasms.

    Conclusions: Additional care including treatment of vasospasm and re-treatment of residual aneurysms should be taken in the intracranial aneurysm patients associated with OSA. Simultaneous treatment of OSA may be beneficial for these patients.

    Patient Care: Simultaneous treatment of obstructive sleep apnea may be beneficial for the intracranial aneurysm patients associated with sleep apnea.

    Learning Objectives: Clinicoradiological outcome was poor in presence of obstructive sleep apnea in the patients with intracranial aneurysm. Additional care including treatment of vasospasm and re-treatment of residual aneurysms should be taken.

    References:

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