Abstract：
BACKGROUND:Complex aneurysm shape is a predominant risk factor for aneurysm rupture but its impact on clinical outcome after clipping remains unclear. The objective of the present study was to compare complications and morbidity after clipping of unruptured single-sac aneurysms (SSAs) and aneurysms with multiple sacs (MSAs). METHODS:A retrospective, single-center study was conducted for patients that were treated between 2010 and 2018. We analyzed surgical parameters, treatment-related complications, and morbidity, defined as any increase in the modified Rankin scale at 3-month follow-up. RESULTS:We identified 101 patients (mean age: 52.9 ± 10.5 years) that underwent clipping for 57 SSAs and 44 MSAs. The two groups were comparable regarding aneurysm size and neck width. Clipping of MSAs was associated with a longer operation time (p = 0.008) and increased use of intraoperative indocyanine green (p = 0.016) than SSAs. Complications occurred more often in the MSA group (29.5%) than in the SSA group (14.0%; p = 0.057). Morbidity was significantly higher in the MSA group (20.5%) than in the SSA group (3.5%, p = 0.009). In the univariate analysis, the odds of morbidity were 7.1 times greater for MSAs than for SSAs (95% CI 1.4-34.7). CONCLUSIONS:Morbidity after microsurgical clipping is significantly increased in MSAs as compared to SSAs. This may be attributed to a more difficult clip placement with stronger manipulation of the aneurysm dome and the surrounding brain tissue.
journal_name
Acta Neurochir (Wien)journal_title
Acta neurochirurgicaauthors
Goertz L,Kasuya H,Hamisch C,Kabbasch C,von Spreckelsen N,Ludyga D,Timmer M,Stavrinou P,Goldbrunner R,Brinker G,Krischek Bdoi
10.1007/s00701-018-3675-9subject
Has Abstractpub_date
2018-11-01 00:00:00pages
2169-2176issue
11eissn
0001-6268issn
0942-0940pii
10.1007/s00701-018-3675-9journal_volume
160pub_type
杂志文章abstract：:The authors describe an approach through the temporal horn of the lateral ventricle which proved to be useful for clipping of a large dorsal type basilar bifurcation aneurysms. It facilitates the preservation of the perforating arteries behind the aneurysm, because it gives sufficient working space to move the aneurys...
journal_title：Acta neurochirurgica
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abstract：:MRI is routinely used in the evaluation and management of patients with failed back surgery syndrome (FBSS). However, its value is unclear in the early detection of signs that can negatively affect that later course of surgical cases. The purpose of the present study is to describe the MR images of early postoperative...
journal_title：Acta neurochirurgica
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abstract：BACKGROUND:Intraoperative navigated ultrasonography has reached clinical acceptance, while published data for the accuracy of some systems are missing. We technically quantified and optimised the accuracy of the integration of an external ultrasonography system into a BrainLab navigation system. METHODS:A high-end ult...
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journal_title：Acta neurochirurgica
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journal_title：Acta neurochirurgica
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journal_title：Acta neurochirurgica
pub_type： 杂志文章,评审
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