Eight-Year Experience Of Endovascular Treatment For Ruptured Intracranial Aneurysms In Kenya: Efficacy And Outcomes Compared To ISAT Historical Controls

Abstract

Introduction: The advent of endovascular treatment for ruptured intracranial aneurysms is now well established worldwide. However, there are few reports as to the treatment outcomes nor the efficacy of coil embolization in the African context and especially in sub-Saharan Africa. We present the initial data over 8 years detailing the initial experience of endovascular therapies in Kenya including indications, methods and outcomes from a single institution. We also compare outcome using historical controls from the ISAT Trail. Methods: We examined prospectively collected data over 8 years from 2015-2023 in continuous hospital data base for patients with aneurysmal subarachnoid haemorrhage treated with coil embolization. Outcome data using the Glasgow Outcome Score (GOS) at 6 months was also collected. We examined for univariate and multivariate associations with mortality and functional outcome using mRS scale. Results: The study comprised 166 patients treated between 2015 and 2023. The mean follow-up was 1 year (range: 0.5-2.5 years). Overall mortality was 11%, and 22% of patients had an unfavourable outcome. There was a significant reduction in mortality (29% vs. 11%) as compared to historical averages in the hospital. This compares with data from the ISAT data. Conclusion: Endovascular therapy is feasible and efficacious. There has been a significant reduction in mortality over the last 3 years as compared to the prior years.