Artikel
Surgical outcome of wide neck aneurysm, part 2 – unruptured aneurysm
Chirurgisches Outcome der breitbasigen Aneurysmen, Part 2 – Inzidentelle Aneurysmen
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Veröffentlicht: | 8. Mai 2019 |
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Gliederung
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Objective: Recently, surgery was presented as an excellent treatment option with high occlusion grade in case of ruptured wide neck aneurysm (rWNA). The aim of this study was to evaluate surgical outcome of unruptured WNA (uWNA) as well.
Methods: This study was conducted with patients surgically treated on an uWNA from 2007 to 2017 in author’s institute. WNA was defined as previously reported in part 1. Surgical outcome was determined by a digital subtraction angiography (DSA) postoperatively and long term outcome was evaluated by DSA or MR-angiography as well. Neurological outcome was evaluated by modified Ranking Scale (mRS) at 6 months’ follow-up.
Results: Of 148 uWNA, basic characteristics (age, sex distribution) were similar with rWNA-group. Twelve of 148 patients (8.1%) had previous SAH and most of the patients were in good admission status (144 of 148; 97.3%). Surgically complete occlusion was achieved in 112 of 148 (75.6%), neck remnants in 30 patients (20.3%) and six patients had residual aneurysm (4.1%). Overall, 88% volume reduction of uWNA was postoperatively achieved. At follow-up (1509 follow-up months), there was no recurrent aneurysm among completely occluded ones. Among the neck remnants, one showed aneurysm growth at follow up of 18 months, however, no additional treatment was required. One of the residual aneurysm was completely occluded at 12 months follow-up and the rests were stable at mean follow up of 7±4.2 months. Favorable outcome was achieved in 140 patients (94.6%) at 6 months’ follow-up.
Conclusion: Surgical treatment of uWNA is a very good treatment option with high occlusion rates with stable results at short- and long-term follow-up. Furthermore, one patient showed complete occlusion at follow-up, and only in one patient with a neck remnant, a small aneurysm growth was identified.