Angiographic and epidemiological characteristics associated with aneurysm remnants after microsurgical clipping

• Published in: Surgical neurology international Vol. 8; no. 1; p. 198
• Main Authors: Dellaretti, Marcos, da Silva Martins, Warley, Dourado, Jules, Faglioni, Wilson, Quadros, Ricardo, de Souza Moraes, Vítor, de Souza Filho, Carlos
• Format: Journal Article
• Language: English
• Published: Pittsford Wolters Kluwer India Pvt. Ltd 01-01-2017; Scientific Scholar; Medknow Publications & Media Pvt Ltd
• Subjects: Age; Aneurysms; Data analysis; Medical imaging; Neurosurgery; Neurovascular: Original; Patients; Software; Surgery; Titanium alloys; Variance analysis; Veins & arteries; angiographic features; epidemiological characteristics; Aneurysm remnants; microsurgical clipping
• ISSN: 2152-7806; 2229-5097; 2152-7806
• DOI: 10.4103/sni.sni_109_17

Background: Despite new techniques for the treatment of cerebral aneurysms, the percentage of aneurysm remnants after surgical intervention seems to be relatively constant. The objective of this study was to assess angiographic and epidemiological features associated with aneurysm remnants after microsurgical clipping.
Methods: This study was conducted from February 2009 to August 2012 on a series of 90 patients with 105 aneurysms referred to the Santa Casa of Belo Horizonte who were surgically treated and angiographically controlled.
Results: Surgical clipping was considered incomplete in 13.3% of the aneurysms. The mean age of cases with an aneurysm remnant was 57.5 years, whereas the mean age without aneurysm remnant was 49.7 years (P = 0.02). Aneurysm remnants were detected more frequently on the internal carotid artery, nevertheless, no statistically significant differences were verified when comparing the locations. Aneurysm size in the preoperative angiography verified that the mean size of aneurysms operated was 6.56 mm, such that in cases showing a postoperative remnant, the mean size was 9.7 mm and in cases with complete clipping it was 6.08 mm (P = 0.02). Postoperative angiography showed that, in cases with residual aneurysm, the number of clips used was higher - a mean of 1.8 for complete clipping and 3.1 for incomplete clipping (P < 0.001).
Conclusions: Aneurysm size and patient age showed significant correlations with residual intracranial aneurysm. The mean number of clips used was higher in cases with incomplete occlusion.