Abstract:
BACKGROUND:Determining the risks of treatment of unruptured intracranial aneurysms is critical in the decision-making process of management. Most studies have reported the results for endovascular or surgical management. Our objective was to better delineate the risk estimates for unruptured intracranial aneurysms treated with surgical or endovascular techniques in a comprehensive fashion, according to the patients' risk profiles. METHODS:Data were gathered from 553 patients with 658 unruptured intracranial aneurysms treated at a single institution from 2014 to 2017. The decision to treat was determined by a projected morbidity that was lower than the natural history rupture risk. Data on aneurysm size, location, patient age, and outcome at the last clinical visit (modified Rankin scale scores) were collected and analyzed retrospectively. RESULTS:The mean patient age was 59 years, and the mean lesion size was 7.3 mm. Microsurgical clipping was used in 251 lesions (38.2%), endovascular coiling in 70 (10.6%), stent-assisted coiling in 89 (13.5%), and a pipeline embolization device in 248 (37.7%). Complications from the procedures or during hospital admission occurred 66 lesions (10% of the total). Of these 66 complications, 28 (4.32% of the total) were non-neurological, treated, and resolved without permanent morbidity. Neurologic complications occurred in 38 procedures (5.7% of the total). Of these, 7 (1%) resulted in a permanent poor outcome (modified Rankin scale score, 3-6). CONCLUSION:Aneurysmal obliteration using endovascular and surgical approaches in a comprehensive fashion has low treatment risks for unruptured aneurysms. The nomograms generated are useful in the discussion with patients and families regarding the risks of total institutional treatment of unruptured aneurysms.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Ogilvy CS,Jordan NJ,Ascanio LC,Enriquez-Marulanda AA,Salem MM,Moore JM,Thomas AJdoi
10.1016/j.wneu.2019.03.005subject
Has Abstractpub_date
2019-06-01 00:00:00pages
e878-e887eissn
1878-8750issn
1878-8769pii
S1878-8750(19)30617-5journal_volume
126pub_type
杂志文章abstract:BACKGROUND:The growing interest in minimally invasive approaches to the thoracic and lumbar spine is mostly secondary to the high surgical morbidity and complication rates associated with conventional open approaches. The objective was to report the largest series of patients with thoracic and lumbar vertebral osteomye...
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journal_title:World neurosurgery
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2013.02.063
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更新日期:2018-11-01 00:00:00
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更新日期:2019-06-01 00:00:00
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更新日期:2017-01-01 00:00:00
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更新日期:2020-11-13 00:00:00
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pub_type: 临床试验,杂志文章
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更新日期:2010-01-01 00:00:00
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更新日期:2014-12-01 00:00:00
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