scholarly journals Postoperative Ischemic Complications in the Surgical Treatment of Unruptured Intracranial Aneurysms.

2003 ◽  
Vol 31 (2) ◽  
pp. 104-110 ◽  
Author(s):  
Toshihiro YASUI ◽  
Masaki KOMIYAMA ◽  
Yoshiyasu IWAI ◽  
Kazuhiro YAMANAKA ◽  
Yasuhiro MATSUZAKA ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Intracranial Aneurysms ◽  
Unruptured Intracranial Aneurysms ◽  
Ischemic Complications

scholarly journals Subarachnoid hemorrhage after surgical treatment of unruptured intracranial aneurysms

2018 ◽  
Vol 129 (2) ◽  
pp. 490-497
Author(s):  
Hidetoshi Matsukawa ◽  
Hiroyasu Kamiyama ◽  
Toshiyuki Tsuboi ◽  
Kosumo Noda ◽  
Nakao Ota ◽  
...  
Keyword(s):  
Risk Factors ◽  
Subarachnoid Hemorrhage ◽  
Surgical Treatment ◽  
Incidence Rate ◽  
Intracranial Aneurysms ◽  
Annual Incidence ◽  
Annual Incidence Rate ◽  
Excellent Outcome ◽  
Unruptured Intracranial Aneurysms ◽  
Average Annual Incidence

OBJECTIVEOnly a few previous studies have investigated subarachnoid hemorrhage (SAH) after surgical treatment in patients with unruptured intracranial aneurysms (UIAs). Given the improvement in long-term outcomes of embolization, more extensive data are needed concerning the true rupture rates after microsurgery in order to provide reliable information for treatment decisions. The purpose of this study was to investigate the incidence of and risk factors for postoperative SAH in patients with surgically treated UIAs.METHODSData from 702 consecutive patients harboring 852 surgically treated UIAs were evaluated. Surgical treatments included neck clipping (complete or incomplete), coating/wrapping, trapping, proximal occlusion, and bypass surgery. Clippable UIAs were defined as UIAs treated by complete neck clipping. The annual incidence of postoperative SAH and risk factors for SAH were studied using Kaplan-Meier survival analysis and Cox proportional hazards regression models.RESULTSThe patients’ median age was 64 years (interquartile range [IQR] 56–71 years). Of 852 UIAs, 767 were clippable and 85 were not. The mean duration of follow-up was 731 days (SD 380 days). During 1708 aneurysm years, there were 4 episodes of SAH, giving an overall average annual incidence rate of 0.23% (95% CI 0.12%–0.59%) and an average annual incidence rate of 0.065% (95% CI 0.0017%–0.37%) for clippable UIAs (1 episode of SAH, 1552 aneurysm-years). Basilar artery location (adjusted hazard ratio [HR] 23, 95% CI 2.0–255, p = 0.0012) and unclippable UIA status (adjusted HR 15, 95% CI 1.1–215, p = 0.046) were significantly related to postoperative SAH. An excellent outcome (modified Rankin Scale score of 0 or 1) was achieved in 816 (95.7%) of 852 cases overall and in 748 (98%) of 767 clippable UIAs at 12 months.CONCLUSIONSIn this large case series, microsurgical treatment of UIAs was found to be safe and effective. Aneurysm location and unclippable morphologies were related to postoperative SAH in patients with surgically treated UIAs.

scholarly journals MR-DWI–Positive Lesions and Symptomatic Ischemic Complications After Coiling of Unruptured Intracranial Aneurysms

Stroke ◽  
2013 ◽  
Vol 44 (3) ◽  
pp. 789-791 ◽  
Author(s):  
Dong-Hun Kang ◽  
Byung Moon Kim ◽  
Dong Joon Kim ◽  
Sang Hyun Suh ◽  
Dong Ik Kim ◽  
...  
Keyword(s):  
Intracranial Aneurysms ◽  
Unruptured Intracranial Aneurysms ◽  
Ischemic Complications

In-hospital Mortality and Morbidity after Surgical Treatment of Unruptured Intracranial Aneurysms in the United States, 1996–2000: The Effect of Hospital and Surgeon Volume

Neurosurgery ◽  
2003 ◽  
Vol 52 (5) ◽  
pp. 995-1009
Author(s):  
Fred G. Barker ◽  
Sepideh Amin-Hanjani ◽  
William E. Butler ◽  
Christopher S. Ogilvy ◽  
Bob S. Carter
Keyword(s):  
United States ◽  
Surgical Treatment ◽  
Length Of Stay ◽  
Intracranial Aneurysms ◽  
High Volume ◽  
The United States ◽  
Surgeon Volume ◽  
Hospital Charges ◽  
Unruptured Aneurysms ◽  
Unruptured Intracranial Aneurysms

Abstract OBJECTIVE We sought to determine the risk of adverse outcome after contemporary surgical treatment of patients with unruptured intracranial aneurysms in the United States. Patient, surgeon, and hospital characteristics were tested as potential outcome predictors, with particular attention to the surgeon's and hospital's volume of care. METHODS We performed a retrospective cohort study with the Nationwide Inpatient Sample, 1996 to 2000. Multivariate logistic and ordinal regression analyses were performed with endpoints of mortality, discharge other than to home, length of stay, and total hospital charges. RESULTS We identified 3498 patients who were treated at 463 hospitals, and we identified 585 surgeons in the database. Of all patients, 2.1% died, 3.3% were discharged to skilled-nursing facilities, and 12.8% were discharged to other facilities. The analysis adjusted for age, sex, race, primary payer, four variables measuring acuity of treatment and medical comorbidity, and five variables indicating symptoms and signs. The statistics for median annual number of unruptured aneurysms treated were eight per hospital and three per surgeon. High-volume hospitals had fewer adverse outcomes than hospitals that handled comparatively fewer unruptured aneurysms: discharge other than to home occurred after 15.6% of operations at high-volume hospitals (20 or more cases/yr) compared with 23.8% at low-volume hospitals (fewer than 4 cases/yr) (P = 0.002). High surgeon volume had a similar effect (15.3 versus 20.6%, P = 0.004). Mortality was lower at high-volume hospitals (1.6 versus 2.2%) than at hospitals that handled comparatively fewer unruptured aneurysms, but not significantly so. Patients treated by high-volume surgeons had fewer postoperative neurological complications (P = 0.04). Length of stay was not related to hospital volume. Charges were slightly higher at high-volume hospitals, partly because arteriography was performed more frequently than at hospitals that handled comparatively fewer unruptured aneurysms. CONCLUSION For patients with unruptured aneurysms who were treated in the United States between 1996 and 2000, surgery performed at high-volume institutions or by high-volume surgeons was associated with significantly lower morbidity and modestly lower mortality.

scholarly journals Validation of Surgical Treatment for Asymptomatic Unruptured Intracranial Aneurysms in View of Patient Quality of Life

2005 ◽  
Vol 33 (1) ◽  
pp. 8-13 ◽  
Author(s):  
Shigeo YAMASHIRO ◽  
Toru NISHI ◽  
Kazunari KOGA ◽  
Tomoaki GOTO ◽  
Daisuke MUTA ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Intracranial Aneurysms ◽  
Unruptured Intracranial Aneurysms

scholarly journals Surgical Treatment of Unruptured Intracranial Aneurysms

1995 ◽  
Vol 23 (6) ◽  
pp. 429-434 ◽  
Author(s):  
Satoshi USHIKOSHI ◽  
Fumio ITOH ◽  
Hisatoshi SAITOH ◽  
Satoshi KURODA ◽  
Kiyohiro HOUKIN ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Intracranial Aneurysms ◽  
Unruptured Intracranial Aneurysms

Treatment of distal unruptured intracranial aneurysms using a surface-modified flow diverter under prasugrel monotherapy: a pilot safety trial

2021 ◽  
pp. neurintsurg-2020-017262
Author(s):  
Luis Henrique de Castro-Afonso ◽  
Guilherme Seizem Nakiri ◽  
Thiago Giansante Abud ◽  
Lucas Moretti Monsignore ◽  
Rafael Kiyuze Freitas ◽  
...  
Keyword(s):  
Intracranial Aneurysms ◽  
Flow Diverter ◽  
Anterior Circulation ◽  
Antiplatelet Medication ◽  
Unruptured Intracranial Aneurysms ◽  
Trial Treatment ◽  
Ischemic Complications ◽  
Carotid Aneurysms ◽  
Surface Modified

BackgroundFlow diverters (FDs) are effective in the treatment of carotid aneurysms. Compared with carotid aneurysms, the treatment of distal intracranial aneurysms with FDs has been associated with a relatively high incidence of complications. Low thrombogenic modified-surface FDs may reduce ischemic complications and allow for the use of a single antiplatelet medication. The aim of this study was to assess the safety and efficacy of the p48 MW HPC Flow Modulation Device (Phenox GmbH, Bochum, Germany) to treat distal intracranial aneurysms used in combination with prasugrel monotherapy.MethodsThis was a single-center, prospective, pivotal, open, single-arm study. Patients were included in this study from December 2019 to September 2020. The primary endpoints were the incidence of any neurologic deficit after treatment until 1 month of follow-up, defined as National Institutes of Health Stroke Scale (NIHSS) ≥1, and the incidence of acute ischemic lesions in magnetic resonance imagin (MRI) images 48 hours after treatment. The secondary endpoint was the rate of complete occlusion of the aneurysms at the 1-month follow-up.ResultsTwenty-one patients harboring 27 distal aneurysms of the anterior circulation were included. Mean age was 57.8 (SD 9.7) years, and 16 patients were female (80%). No patient had neurologic symptoms at the 1-month follow-up. Four patients (20%) had asymptomatic acute brain ischemic lesions on MRI. Complete aneurysm occlusion occurred in 9/27 (33.3%) aneurysms at the 1-month follow-up.ConclusionIn this pilot safety trial, treatment of distal intracranial aneurysms with p48 MW HPC under monotherapy with prasugrel appeared to be safe.

Is Age a Risk Factor for Poor Outcome of Surgical Treatment of Unruptured Intracranial Aneurysms?

2016 ◽  
Vol 94 ◽  
pp. 222-228 ◽  
Author(s):  
Hidetoshi Matsukawa ◽  
Hiroyasu Kamiyama ◽  
Toshiyuki Tsuboi ◽  
Kosumo Noda ◽  
Nakao Ota ◽  
...  
Keyword(s):  
Risk Factor ◽  
Surgical Treatment ◽  
Intracranial Aneurysms ◽  
Poor Outcome ◽  
Unruptured Intracranial Aneurysms
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