Chang Ki Jang1, Keun Young Park1, Jae Whan Lee1, Seung Kon Huh1, Jung Hoon Kim2, Sunghan Kim3, Joonho Chung4. 1. Department of Neurosurgery, Severance Hospital, Stroke Center, Yonsei University College of Medicine, Seoul, Korea. 2. Department of Radiology, Busan Paik Hospital, Inje University, Busan, Korea. 3. Department of Neurosurgery, Seoul Medical Center, Seoul, Korea. 4. Department of Neurosurgery, Severance Hospital, Stroke Center, Yonsei University College of Medicine, Seoul, Korea; Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Korea. Electronic address: ns.joonho.chung@gmail.com.
Abstract
OBJECTIVE: To describe our experiences with microsurgical treatment of unruptured anterior choroidal artery (AchA) aneurysms, and to evaluate the incidence of and risk factors for procedure-related complications. METHODS: The study included 110 patients treated between January 2012 and December 2016. All patients met the following criteria: 1) microsurgical treatment of an unruptured AchA aneurysm was performed; and 2) clinical and radiographic follow-up data were available, including findings from preoperative digital subtraction angiography. The incidence of and risk factors for procedure-related complications were retrospectively evaluated. The χ2 test and Mann-Whitney U test were used in statistical analysis, and univariate analysis and multivariate logistic regression analysis were conducted. RESULTS: Procedure-related complications occurred in 5 patients (4.5%), including symptomatic complications in 4 patients (3.6%) and asymptomatic complications in 1 patient (0.9%). Multivariate logistic regression analysis indicated that the angle between the vertical line to the cranial base and the axis of the communicating segment of the internal carotid artery (MiC angle) (odds ratio [OR], 1.66; 95% confidence interval [CI], 1.13-5.26; P = 0.038) and the angle between the projection line of the aneurysmal dome and the axis of the communicating segment of the internal carotid artery (DC angle) (OR, 3.82; 95% CI, 1.49-11.7; P = 0.014) were independent risk factors for procedure-related complications. CONCLUSIONS: When microsurgical treatment of unruptured AchA aneurysms was performed, the procedure-related complication rate was 4.5%. Patients with AchA aneurysms with a smaller MiC angle and smaller DC angle may be at a higher risk of procedure-related complications when undergoing microsurgical treatment.
OBJECTIVE: To describe our experiences with microsurgical treatment of unruptured anterior choroidal artery (AchA) aneurysms, and to evaluate the incidence of and risk factors for procedure-related complications. METHODS: The study included 110 patients treated between January 2012 and December 2016. All patients met the following criteria: 1) microsurgical treatment of an unruptured AchA aneurysm was performed; and 2) clinical and radiographic follow-up data were available, including findings from preoperative digital subtraction angiography. The incidence of and risk factors for procedure-related complications were retrospectively evaluated. The χ2 test and Mann-Whitney U test were used in statistical analysis, and univariate analysis and multivariate logistic regression analysis were conducted. RESULTS: Procedure-related complications occurred in 5 patients (4.5%), including symptomatic complications in 4 patients (3.6%) and asymptomatic complications in 1 patient (0.9%). Multivariate logistic regression analysis indicated that the angle between the vertical line to the cranial base and the axis of the communicating segment of the internal carotid artery (MiC angle) (odds ratio [OR], 1.66; 95% confidence interval [CI], 1.13-5.26; P = 0.038) and the angle between the projection line of the aneurysmal dome and the axis of the communicating segment of the internal carotid artery (DC angle) (OR, 3.82; 95% CI, 1.49-11.7; P = 0.014) were independent risk factors for procedure-related complications. CONCLUSIONS: When microsurgical treatment of unruptured AchA aneurysms was performed, the procedure-related complication rate was 4.5%. Patients with AchA aneurysms with a smaller MiC angle and smaller DC angle may be at a higher risk of procedure-related complications when undergoing microsurgical treatment.
Authors: Pablo García Feijoo; Javier Manuel Saceda Gutiérrez; Remedios Frutos Martínez; Miguel Sáez Alegre; Catalina Vivancos Sánchez; Fernando Eliseo Carceller Benito Journal: Childs Nerv Syst Date: 2020-09-15 Impact factor: 1.475