Paraclinoid aneurysms: Outcome analysis and technical remarks of a microsurgical series
| Autor: | Renato Galzio, Matias Baldoncini, Alice Giotta Lucifero, Samer K. Elbabaa, Sabino Luzzi, Mattia Del Maestro |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
medicine.medical_specialty
RD1-811 Ruptured aneurysms Ophthalmic aneurysms medicine.medical_treatment Outcome analysis Clinical onset Aneurysm Anterior clinoidectomy medicine cardiovascular diseases RC346-429 Abducens nerve Flow diverter business.industry Paraclinoid aneurysms Mortality rate Clipping Flow diverters Clipping (medicine) medicine.disease Surgery cardiovascular system Neurology (clinical) Microneurosurgery Neurology. Diseases of the nervous system business |
| Zdroj: | Interdisciplinary Neurosurgery, Vol 27, Iss, Pp 101373-(2022) |
| ISSN: | 2214-7519 |
| Popis: | Introduction A critical appraisal of the surgical results of paraclinoid aneurysms is essential in the flow diverters era. This study overviews the data of a three-decade surgical series of paraclinoid aneurysms while focusing on their technical remarks. Methods Overall data of a surgical consecutive series of paraclinoid aneurysms treated between 1993 and 2021 were retrospectively reviewed. Aneurysms were classified according to size and projection. Indications for surgery were different based on the availability of endovascular techniques, especially flow diverter, at the time of treatment. A statistical comparison between ruptured and unruptured aneurysms was accomplished. Results 58 patients were operated upon. Ophthalmic aneurysms were 68%, giant aneurysms 20%, and ruptured aneurysms 45%. Clipping and bypass were executed in 91% and 9% of cases, respectively. An mRS of 0–2 was achieved in 77% of patients, independently by the clinical onset. The mortality rate was 5%. Visual field was improved or unchanged in 71% of elective patients, whereas the incidence of de novo third and sixth cranial nerves deficit was 8% and 5%, respectively. On an average follow-up of 53.3 ± 38 months, a complete and durable aneurysm exclusion was achieved in 91.3% of patients with a single surgery. Conclusions Microneurosurgery is still a valuable treatment option for selected ruptured and unruptured paraclinoid aneurysms. In our experience, it has proven to be definitive and durable, with acceptable morbidity and mortality. Clipping is the treatment of choice in most surgical cases, achieving a good visual outcome in symptomatic patients. |
| Databáze: | OpenAIRE |
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