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Park CK, Shin HS, Choi SK, et al. Clinical analysis and surgical considerations of atherosclerotic cerebral aneurysms: experience of a single center. J Cerebrovasc Endovasc Neurosurg. 2014;16(3):247-53doi: 10.7461/jcen.2014.16.3.247.
Park, C. K., Shin, H. S., Choi, S. K., Lee, S. H., & Koh, J. S. (2014). Clinical analysis and surgical considerations of atherosclerotic cerebral aneurysms: experience of a single center. Journal of cerebrovascular and endovascular neurosurgery, 16(3), 247-53. https://doi.org/10.7461/jcen.2014.16.3.247
Park, Chang Kyu, et al. "Clinical analysis and surgical considerations of atherosclerotic cerebral aneurysms: experience of a single center." Journal of cerebrovascular and endovascular neurosurgery vol. 16,3 (2014): 247-53. doi: https://doi.org/10.7461/jcen.2014.16.3.247
Park CK, Shin HS, Choi SK, Lee SH, Koh JS. Clinical analysis and surgical considerations of atherosclerotic cerebral aneurysms: experience of a single center. J Cerebrovasc Endovasc Neurosurg. 2014 Sep;16(3):247-53. doi: 10.7461/jcen.2014.16.3.247. Epub 2014 Sep 30. PMID: 25340027; PMCID: PMC4205251.
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J Cerebrovasc Endovasc Neurosurg. 2014 Sep;16(3):247-53. doi: 10.7461/jcen.2014.16.3.247. Epub 2014 Sep 30.

Clinical analysis and surgical considerations of atherosclerotic cerebral aneurysms: experience of a single center.

Journal of cerebrovascular and endovascular neurosurgery

Chang Kyu Park, Hee Sup Shin, Seok Keun Choi, Seung Hwan Lee, Jun Seok Koh

Affiliations

  1. Department of Neurosurgery, KyungHee University Hospital, Seoul, Korea.
  2. Department of Neurosurgery, KyungHee University Hospital at Gangdong, Seoul, Korea.

PMID: 25340027 PMCID: PMC4205251 DOI: 10.7461/jcen.2014.16.3.247

Abstract

OBJECTIVE: Atherosclerotic cerebral aneurysms are known to increase occurrence of thromboembolic events and occlusion of perforator vessels intraoperatively due to pathological changes in the vessels themselves. In the current study, we analyzed the points to be considered during surgery for atherosclerotic cerebral aneurysms and the postoperative results.

MATERIALS AND METHODS: We retrospectively reviewed the medical records, radiological results, and surgical records, including intraoperative video recordings and photographs, of 262 patients who underwent cerebral aneurysm surgery. We then performed a detailed analysis of aneurysm features, surgical methods, and clinical outcomes.

RESULTS: Among 278 aneurysms in 262 patients, 73 aneurysms in 67 patients showed atherosclerotic features (atherosclerotic group, AG), and 205 aneurysms in 195 patients showed no evidence of atherosclerosis (non-atherosclerotic group, NAG). In the AG, clipping with multiple permanent clips was performed in 14 aneurysms, and clip slippage was found in four cases. Six AG cases had a remnant neck after clipping, which was significantly more frequent than in the NAG (p < 0.05). Clinical outcomes and surgery-related complications did not differ significantly between the two groups.

CONCLUSION: In the surgical repair of aneurysms, the incidence of ischemia, which is irreversible or severe, might be greater in atherosclerotic than in non-atherosclerotic aneurysms. In addition, multiple clips might be applied to atherosclerotic aneurysms for effective obliteration and an aneurysm neck might be left to avoid a region of atheroma.

Keywords: Intracranial aneurysm; atherosclerosis; surgical procedure

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