Long-Term Neurological and Radiological Results of Consecutive 63 Unruptured Anterior Communicating Artery Aneurysms Clipped via Lateral Supraorbital Keyhole Minicraniotomy
| Autor: | Kojiro Wada, Satoru Takeuchi, Satoshi Tomura, Hajime Arai, Yasuaki Nakao, Terushige Toyooka, Naoki Otani, Takuji Yamamoto, Arata Tomiyama, Kentaro Mori |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Neurosurgical Procedures 03 medical and health sciences Imaging Three-Dimensional 0302 clinical medicine Aneurysm Modified Rankin Scale medicine.artery medicine Humans cardiovascular diseases 030212 general & internal medicine Aged Computed tomography angiography Mini–Mental State Examination medicine.diagnostic_test business.industry Beck Depression Inventory Intracranial Aneurysm Clipping (medicine) Perioperative Middle Aged medicine.disease Cerebral Angiography Surgery Anterior communicating artery Treatment Outcome cardiovascular system Female Neurology (clinical) Tomography X-Ray Computed business Craniotomy 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Operative Neurosurgery. 14:95-103 |
| ISSN: | 2332-4260 2332-4252 |
| Popis: | BACKGROUND Treatments for unruptured anterior communicating artery (AcomA) aneurysm have relatively high morbidity. OBJECTIVE To assess the lateral supraorbital keyhole approach for safe and complete clipping of unruptured AcomA aneurysm and evaluate the long-term clinical and radiological outcomes, including cognitive and depressive status. METHODS A total of 63 patients (aged 41-79 yr, mean 64 yr) with relatively small AcomA aneurysms clipped via the lateral supraorbital approach were retrospectively analyzed among the 105 AcomA aneurysms treated by clipping from 2005 to 2014. Neurological and cognitive functions were examined by several scales, including the modified Rankin Scale (mRS) and Mini-Mental Status Examination. The depressive state was assessed using the Beck Depression Inventory and Hamilton Depression Scale. The state of clipping was assessed 1 yr and then every few years after the operation by 3-dimensional computed tomography angiography. RESULTS Complete neck clipping was confirmed in 62 aneurysms (98.4%). Perioperative complications occurred in 5 patients (5/63; mild frontalis muscle weakness in 3, anosmia in 1, and meningitis in 1). The mean clinical follow-up period was 5.2 ± 2.1 yr. No patient showed an mRS score more than 2 and all were completely independent in daily life. The depression scores were significantly improved after surgery. The overall mortality was 0% and overall morbidity (mRS score > 2 or Mini-Mental Status Examination score < 24) was 1.6%. All completely clipped aneurysms did not show any recurrence during the mean follow-up period of 4.9 ± 2.1 yr. CONCLUSION Lateral supraorbital keyhole approach to clip relatively small unruptured AcomA aneurysm promises less invasive and durable treatment. |
| Databáze: | OpenAIRE |
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