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Microsurgical clipping of ruptured anterior choroidal artery aneurysms: Incidence of and risk factors for ischemic complications

Authors
 So Yeon Kim  ;  Hong Jun Jeon  ;  Sunghan Kim  ;  Joonho Chung  ;  Keun Young Park  ;  Seung Kon Huh  ;  Jae Whan Lee 
Citation
 CLINICAL NEUROLOGY AND NEUROSURGERY, Vol.195(105884), 2020-08 
Journal Title
CLINICAL NEUROLOGY AND NEUROSURGERY
ISSN
 0303-8467 
Issue Date
2020-08
Keywords
Anterior choroidal artery ; Intracranial aneurysm ; Ischemic complication ; Ruptured aneurysm ; Temporary arterial occlusion ; Temporary clipping
Abstract
Objective: Temporary clipping of the internal carotid artery can be required during microsurgery of a ruptured anterior choroidal artery (AchoA) aneurysm. Although it is suspected that such temporary clipping might be related to ischemic complications following surgery, no detailed analysis has been reported yet.

Patients and methods: Eighty-nine patients with ruptured AchoA aneurysms treated by microsurgical clipping were recruited between January 1996 and December 2017. Patient medical records, radiographic data, and intraoperative video findings were retrospectively reviewed. Multivariate logistic regression analysis was conducted to investigate the risk factors for treatment-related ischemic complications.

Results: Treatment-related ischemic complications occurred in eight (9.0 %) patients, all of whom underwent temporary clipping during microsurgery. Patients who did not undergo temporary clipping (n = 20) did not experience treatment-related ischemic complications. Among patients who underwent temporary clipping (n = 69), multivariate logistic regression analyses indicated that the total duration, number of attempts, and longest time per attempt were not risk factors for poor clinical outcome at discharge. However, the longest time per attempt was identified as the only independent risk factor for treatment-related ischemic complications (odds ratio, 2.883; 95 % confidence interval, 1.725-6.525; P = 0.042).

Conclusion: The longest time per attempt might be associated with a higher risk of treatment-related ischemic complications during microsurgery for ruptured AchoA aneurysms. Treatment-related ischemic complications may be minimized by intermittent application of temporary clipping during surgery.
Full Text
https://www.sciencedirect.com/science/article/pii/S0303846720302274
DOI
10.1016/j.clineuro.2020.105884
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Park, Keun Young(박근영)
Lee, Jae Whan(이재환)
Chung, Joon Ho(정준호)
Huh, Seung Kon(허승곤)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/179694
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