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Tytuł:
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Microsurgical clipping of unruptured middle cerebral artery bifurcation aneurysms: incidence of and risk factors for procedure-related complications.
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Autorzy:
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Chung J; Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Hong CK; Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Shim YS; Department of Neurosurgery, Inha University School of Medicine, Incheon, Republic of Korea.
Joo JY; Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Lim YC; Department of Neurosurgery, Ajou University School of Medicine, Suwon, Republic of Korea.
Shin YS; Department of Neurosurgery, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
Kim YB; Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: .
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Źródło:
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World neurosurgery [World Neurosurg] 2015 May; Vol. 83 (5), pp. 666-72. Date of Electronic Publication: 2015 Feb 03.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Original Publication: New York : Elsevier
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MeSH Terms:
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Cerebral Revascularization/*methods
Intracranial Aneurysm/*surgery
Middle Cerebral Artery/*surgery
Adult ; Aged ; Aged, 80 and over ; Angiography, Digital Subtraction ; Cerebral Revascularization/adverse effects ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Middle Aged ; Postoperative Complications/epidemiology ; Retrospective Studies ; Risk Factors
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Contributed Indexing:
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Keywords: Complications; Intracranial aneurysm; Microsurgical clipping; Middle cerebral artery; Predictors; Unruptured aneurysm
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Entry Date(s):
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Date Created: 20150210 Date Completed: 20150803 Latest Revision: 20160519
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Update Code:
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20240104
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DOI:
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10.1016/j.wneu.2015.01.023
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PMID:
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25662765
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Objective: To report our experiences in microsurgical clipping of unruptured middle cerebral artery (MCA) bifurcation aneurysms and to evaluate the incidence of and risk factors for procedure-related complications.
Methods: The study comprised 416 patients treated between March 2003 and February 2014. All patients met the following criteria: 1) microsurgical clipping of an unruptured MCA bifurcation aneurysm was performed, and 2) clinical and radiographic follow-up data were available including preoperative digital subtraction angiography. The incidence of and risk factors for procedure-related complications were retrospectively evaluated.
Results: Procedure-related complications occurred in 15 (3.6%) patients, including asymptomatic complications in 10 (2.4%) patients and symptomatic complications in 5 (1.2%) patients. Multivariate logistic regression analysis showed that posteroinferior projection of the aneurysm (odds ratio = 2.814, 95% confidence interval = 0.995-6.471, P = 0.042), distance between the internal carotid artery bifurcation and the MCA bifurcation (Dt) in a linear line (odds ratio = 1.813, 95% confidence interval = 0.808-6.173, P = 0.043), and horizontal angle between the vertical line to the base of the skull and Dt (odds ratio = 2.046, 95% confidence interval = 1.048-10.822, P = 0.048) were independent risk factors for procedure-related complications.
Conclusions: When performing clipping of unruptured MCA bifurcation aneurysms, the procedure-related complication rate was 3.6%. Patients with MCA bifurcation aneurysms with posteroinferior projection, shorter Dt, and larger horizontal angle may be at a higher risk of procedure-related complications when performing microsurgical clipping.
(Copyright © 2015 Elsevier Inc. All rights reserved.)
Comment in: World Neurosurg. 2015 Aug;84(2):222-3. (PMID: 25862109)
Comment in: World Neurosurg. 2015 Sep;84(3):620-2. (PMID: 25871781)
Comment in: World Neurosurg. 2015 Sep;84(3):618-9. (PMID: 25871784)
Comment in: World Neurosurg. 2015 Oct;84(4):884-5. (PMID: 26092531)
