| Title: | A Retrospective Study in Microsurgical Procedures of Large and Giant Intracranial Aneurysms: An Outcome Analysis |
| Author(s): | Balaji A; Rajagopal N; Yamada Y; Teranishi T; Kawase T; Kato Y; |
| Address: | "Department of Neurosurgery, Kovai Medical Centre and Hospital, Coimbatore, India. Department of Neurosurgery, Sri Sathya Sai Institute of Higher Medical Sciences, Bangalore, India. Department of Neurosurgery, Fujita Health University, Banbuntane Hotokukai Hospital, Nagoya, Japan" |
| DOI: | 10.1016/j.wnsx.2019.100007 |
| ISSN/ISBN: | 2590-1397 (Electronic) 2590-1397 (Linking) |
| Abstract: | "OBJECTIVE: Intracranial aneurysms are considered large if >10 mm and giant if >25 mm. The risk of aneurysmal rupture compounds with increase in size of the aneurysm, thus, warranting appropriate intervention. In this study, we have analyzed the outcome and effectiveness of microsurgical procedures in large and giant aneurysms. METHODS: A retrospective analysis of all the patients who underwent microsurgical procedures for large and giant cerebral aneurysms from 2014-2018 in our institute was conducted. There were a total of 52 patients, in which direct clipping was performed in 42 (80.7%) patients, proximal trapping in 3 (5.7%) patients, trapping with bypass in 3 (5.7%) patients, suction decompression in 3 (5.7%) patients, and 1 (1.9%) patient underwent surgical reconstruction. RESULTS: Among the 52 patients, in the postoperative period, 1 (1.9%) patient became comatose, 1 (1.9%) patient developed hemiplegia, 1 (1.9%) patient had a transient hemiparesis, and 1 (1.9%) patient had transient lower cranial nerve palsy. Two (3.8%) patients had chronic subdural hematoma during the 3-month follow-up. There was no mortality in our series. CONCLUSIONS: There are several treatment strategies available to manage large and giant cerebral aneurysms. In this study, we had minimal morbidity (3.8%), favorable outcome (96.1%), and no mortality. Therefore, we would like to conclude that appropriate microsurgical procedures, in experienced hands, can be considered as first line in the management for large and giant intracranial aneurysms, especially those with complex anatomy, wide neck, mass effect, partial thrombosis, and the presence of critical perforating vessels from the aneurysm wall" |
| Keywords: | "3D, 3-Dimensional BTO, Balloon test occlusion Bypass CFD, Computational fluid dynamics CTA, Computed tomography angiogram Clipping Diva DIVA, Dual image video angiography DSA, Digital subtraction angiography GOS, Glasgow Outcome Scale Giant ICA, Internal;" |
| Notes: | "PubMed-not-MEDLINEBalaji, Arun Rajagopal, Niranjana Yamada, Yasuhiro Teranishi, Takao Kawase, Tsukasa Kato, Yoko eng 2019/06/21 World Neurosurg X. 2019 Jan 9; 2:100007. doi: 10.1016/j.wnsx.2019.100007. eCollection 2019 Apr" |
