Long-Term Outcomes of Endovascular Treatment of Cerebral Aneurysms in The Acute Period of Subarachnoid Hemorrhage

Objective. To assess the long-term outcomes of endovascular treatment in patients with aneurysmal subarachnoid hemorrhage (SAH) who underwent endovascular treatment within 72 hours from the onset of hemorrhage.

Material and Methods. The study included 120 patients who underwent endovascular embolization of a ruptured cerebral aneurysm during the acute phase of SAH. Patients were stratified into two groups: early (n = 60) and ultra-early (n = 60) embolization. Functional outcomes were evaluated using the modified Rankin Scale (mRS) with long-term follow-up of up to 10 years.

Results. Long-term data were available for 101 of the 120 patients (84.2%). A favorable outcome (mRS 0–2) was recorded in 72.3% of patients, moderate to severe neurological deficit (mRS 3–5) in 5.0%, and long-term mortality was 23.8%. Survival analysis revealed no significant differences between the early and ultra-early embolization groups (p = 0.924). Multivariate analysis confirmed a significant impact of age and the degree of occlusion according to the Raymond–Roy classification on prognosis.

Conclusion. Endovascular embolization demonstrates high efficacy in the treatment of ruptured aneurysms, providing favorable functional outcomes in the majority of patients. The timing of intervention (early vs. ultra-early) does not significantly affect long-term survival.

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