Clip ligation of unruptured intracranial aneurysms: A prospective midterm outcome study
Acta Neurochirurgica, cilt.154, sa.7, ss.1135-1144, 2012 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 154 Sayı: 7
- Basım Tarihi: 2012
- Doi Numarası: 10.1007/s00701-012-1397-y
- Dergi Adı: Acta Neurochirurgica
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Sayfa Sayıları: ss.1135-1144
- Anahtar Kelimeler: Late follow-up angiography, Midterm clinical outcome, Surgical clipping, Unruptured intracranial aneurysm
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background We conducted a prospective study to investigate the clinical and radiological outcome in a surgical case series of 176 patients with 203 unruptured intracranial aneurysms (UIA). Methods The success of aneurysm obliteration was assessed within 2 weeks after surgery by digital subtraction angiography (DSA). Patients also underwent angiography 5 years after surgery. Clinical outcomes were assessed using the modified Rankin Scale (mRS). All predictors of poor surgical outcomes were assessed using an exact logistic regression. Results Overall, 83%of the patients had a good outcome (mRS score 0 or 1); 10.8 % of the patients had a slight disability (mRS score 2), and 6.2 % of the patients had a moderate or moderatesevere disability (mRS score 3 or 4). The mortality rate was 0% overall. The most important predictors of outcome were presence of history of ischemic cerebrovascular disease and postoperative stroke. Complete aneurysm occlusion was achieved in 93.5 % of all aneurysms. Sixty percent of treated aneurysms were checkedwith late follow-up DSA. No cases of hemorrhage from a surgically obliterated UIAwere documented in this series during the 7.3±1.4 (SD)-year follow-up period. Conclusions If patients are carefully selected and individually assigned to their optimum treatment modality, IUAs can be obliterated by surgery with a low percentage of unfavorable outcomes. © Springer-Verlag 2012.