AI Article Synopsis
- The study examines the outcomes of surgical clipping for unruptured intracranial aneurysms, focusing on patients with single versus multiple aneurysms and identifying risk factors for complications and poor outcomes.
- It involved a retrospective analysis of 82 patients treated between 2020-2023, finding a 12.2% complication rate with 0% mortality and good functional outcomes in 98.9% of cases.
- Results suggest that microsurgery is a safe and effective treatment option, with a recommendation for a multimodal management approach based on both clinical and radiological findings.
Article Abstract
Background And Objectives: The prevalence of unruptured intracranial aneurysms is 1-3%. The annual rupture rate increases in patients with multiple aneurysms that presented a previous hemorrhage from another aneurysm.
Objectives: To evaluate outcomes of clipping unruptured aneurysms, comparing patients with single or multiple aneurysms clipped, describe the complications related to surgery and to identify risk factors predicting an unfavorable outcome.
Materials And Methods: Retrospective study including patients who underwent clipping of unruptured aneurysms between 2020-2023 at our center. Occlusion rate, complications, and functional outcome were analyzed. Risk factors for poor prognosis are identified using univariate model.
Results: 82 patients with 114 aneurysms were treated with microsurgery. Multiple aneurysms were clipped in 22 patients. A mini-open approach was used in 86,5% of cases. Complete occlusion in angio3D was found in 78.6% of clipped aneurysms. Complication rate was 12.2%, including asymptomatic cases. Mortality was 0%. The probability of 1 point mRS worsening was 7.3% and 2 or more points was 1.2%, with a good functional outcome in 98.9%. Clipping multiple aneurysms, miniopen approaches, or surgery in patients with previous subarachnoid hemorrhage did not increase the risk of complications. Posterior circulation aneurysms surgery increased the risk of ischemia.
Conclusions: The management for unruptured intracranial aneurysms should be multimodal and based on clinical and radiological outcomes. Microsurgery is a valid and safe technique, with 0% mortality and bleeding rates and 1,2% rate of severe morbidity in our series.
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| http://dx.doi.org/10.1016/j.neucie.2024.07.007 | DOI Listing |
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