22. European Stroke Conference 33 Intracerebral/subarachnoid haemorrhage and venous diseases IS THERE AN INCREASE IN PERI-PROCEDURAL COMPLICATIONS WITH URGENT COILING IN SUBARACHNOID HAEMORRHAGE? J.A. Matias-Guiu1, J. Avecillas-Chasín2, C. Serna-Candel3, L. López-Ibor4, A. Gil5, G. Gó-mez- Bustamante6, L. San Román7, G. Rodríguez-Boto8, J. Matias-Guiu9 Department of Neurology. Institute of Neurosciences, IdISSC. Hospital Clinico San Car-los, Madrid, SPAIN1, Department of Neurosurgery. Institute of Neurosciences, IdISSC. Hospital Clinico San Carlos, Madrid, SPAIN2, Department of Neurology. Institute of Neurosciences, IdIS-SC. Hospital Clinico San Carlos, Madrid, SPAIN3, Neurointerventional Unit. Hospital Clinico San Carlos, Madrid, SPAIN4, Neurointerventional Unit. Hospital Clinico San Carlos, Madrid, SPAIN5, Department of Neurosurgery. Institute of Neurosciences, IdISSC. Hospital Clinico San Carlos, Ma-drid, SPAIN6, Neurointerventional Unit. Hospital Clinico San Carlos, Madrid, SPAIN7, Department of Neurosurgery. Institute of Neurosciences, IdISSC. Hospital Clinico San Carlos, Madrid, SPAIN8, Department of Neurology. Institute of Neurosciences, IdISSC. Hospital Clinico San Carlos, Madrid, SPAIN9 Background. Rebleeding is the major complication of subarachnoid haemorrhage (SAH). This com-plication occurs mainly within the first hours and worsens clinical outcome in a dramatic way. Ur-gent treatment of the aneurysm may prevent rebleeding and improve the clinical outcome, but may also determine an increase in peri-procedural complications due to suboptimal conditions of treat-ment such as fatigue or less skilled personnel. However, studies that evaluate this disadvantage of early treatment are lacking. Methods. Retrospective study of patients with SAH treated in our centre with coiling from 2009 to 2012. Urgent treatment was defined as treatment performed within the first 3-hours since the diag-nosis by imaging was established, or if was performed during non-working hours. Peri-procedural complications in patients treated urgently (group 1) vs programmed (group 2) were compared. Results. 68 patients were treated. 20 patients (29.4%) were treated urgently, and 48 patients (70.6%) programmed. 42 (61,8%) patients were treated in the first 24 hours since the onset of haemorrhage. Complete obliteration of the aneurysm was achieved in 19 (95%) in group 1 and 38 (79.1%) in group 2 (p=0.28). 2 patients (10%) (group 1) and 7 patients (14.5%) (group 2) required a second session of embolization (p=0.4). Peri-procedural complications occurred in 6 (30%, group 1) and 12 (25%, group 2, p=0.44), but morbidity was only evident in one case in both groups. Re-treatment of the aneurysm during the first year of follow-up was necessary 1 and 2 cases in groups 1 and 2, re-spectively. 2 patients required surgical clipping after endovascular treatment, both in group 2. Conclusions. Treatment performed under urgent and non-optimal conditions is safe and is not as-sociated to a greater rate of complications or need of re-treatment. According to the results of this study, there should be no reason to delay the treatment. 600 © 2013 S. Karger AG, Basel Scientific Programme E-Poster Terminal 6 34 Intracerebral/subarachnoid haemorrhage and venous diseases Prognostic value of Plasma β--amyloid levels in Patients with Acute Intracerebral Hemor-rhage J. Martí-Fàbregas1, R. Delgado-Mederos2, D. Carrera3, L. Dinia4, R. Marín5, N. Pérez de la Ossa6, M. Alonso de Leciñana7, M. Rodríguez-Yáñez8, J. Sanahuja9, F. Purroy10, 11, A. Arce12, C. Guar-dia- Laguarta13, A. Lleó14 RENEVAS Hospital de la Santa Creu i Sant Pau, Barcelona, SPAIN1, Hospital de la Santa Creu i Sant Pau, Barcelona, SPAIN2, Hospital de la Santa Creu i Sant Pau, Barcelona, SPAIN3, Hospital de la Santa Creu i Sant Pau, Barcelona, SPAIN4, Hospital de la Santa Creu i Sant Pau, Barcelona, SPAIN5, Hos-pital Germans Trias i Pujol, Badalona, SPAIN6, Hospital Ramón y Cajal, Madrid, SPAIN7, Complejo Universitario Santiago de Compostela, Santiago de Compostela, SPAIN8, Hospital Arnau de Vilano-va, Lleida, SPAIN9, Hospital Arnau de Vilanova, Lleida, SPAIN10, , , 11, Hospital de Donostia, Donostia, SPAIN12, Hospi-tal de la Santa Creu i Sant Pau, Barcelona, SPAIN13, Hospital de la Santa Creu i Sant Pau, Barcelo-na, SPAIN14 Background The cerebrovascular deposition of the β-amyloid peptide (Aβ) impairs the function and structural integrity of brain blood vessels. We tested the hypothesis that the levels of plasmaAβ may be related to the outcome in patients with Intracerebral Hemorrhage (ICH). Methods We prospectively includ-ed patients with spontaneous ICH within the first 24 hours after onset in a multicentre study (6 hos-pitals). We excluded cases due to oral anticoagulants, tumour or arterio-venous malformation. We measured plasma Aβ40 and Aβ42 using standard ELISA techniques and the values were logarithm transformed. We recorded age, sex, vascular risk factors, NIHSS score at admission, blood glucose, temperature and blood pressure at admission, presence of intraventricular hemorrhage (IVH), lo-calization (deep/lobar), suspected etiology and volume of the admission hematoma (ABC/2 meth-od). We obtained the modified Rankin scale (mRS) score at 3 months and a favourable outcome was defined as mRS 0-2. Bivariate and multivariate regression analyses were performed. Results We studied 160 patients (mean age 73.8±11.3 y, 59.4% were men). A favourable outcome was ob-served in 64 (40%) patients. In bivariate analysis, outcome was associated with age (p<0.0001), sex (p=0.009), diabetes (p=0.004), alcohol abuse (p=0.01), IVH (p<0.001), blood glucose (p=0.001), NIHSS score (p<0.0001), Volume (p<0.0001), levels of Aβ42 (p=0.048) and Aβ40 (p=0.02). The multivariate analysis showed that increasing age (OR 0.93, 95%CI 0-89-0.96, p<0.0001), higher ad-mission NIHSS score (OR 0.79, 95%CI 0.72-0.86, p<0.0001), presence of diabetes (OR 0.2, 95%CI 0.06-0.7, p=0.011) and Aβ42 levels (OR 0.015 95%CI 0.000-0.523, p=0.02) were independently associated to a decreased likelihood of a favourable outcome. Levels of Aβ40 and Aβ42 were not as-sociated with localization, etiology or volume of ICH. Conclusion In patients with acute ICH, higher levels of plasma Aβ42 are associated with a worse functional outcome.
Karger_ESC London_2013
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