gms | German Medical Science

67th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Korean Neurosurgical Society (KNS)

German Society of Neurosurgery (DGNC)

12 - 15 June 2016, Frankfurt am Main

Institutional 15 years experience in the treatment of incidental aneurysms

Meeting Abstract

  • Julia Mikloss - Neurochirurgische Klinik und Poliklinik, Universitätsmedizin Mainz, Germany
  • Ali Ayyad - Neurochirurgische Klinik und Poliklinik, Universitätsmedizin Mainz, Germany
  • Naureen Keric - Neurochirurgische Klinik und Poliklinik, Universitätsmedizin Mainz, Germany
  • Mirjam Renovanz - Neurochirurgische Klinik und Poliklinik, Universitätsmedizin Mainz, Germany
  • Alf Giese - Neurochirurgische Klinik und Poliklinik, Universitätsmedizin Mainz, Germany
  • Sven R. Kantelhardt - Neurochirurgische Klinik und Poliklinik, Universitätsmedizin Mainz, Germany

Deutsche Gesellschaft für Neurochirurgie. 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS). Frankfurt am Main, 12.-15.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocMO.12.09

doi: 10.3205/16dgnc065, urn:nbn:de:0183-16dgnc0655

Published: June 8, 2016

© 2016 Mikloss et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objective: The decision whether to treat incidental cerebral aneurysms or not is based on the treatment risk and the natural history. To assess the individual situation it is therefore important to know the efficiency and complication rate of the suggested treatment. We investigated the results of all incidental aneurysms treated in our institution within the last 15 years.

Method: We performed a retrospective analysis of patient records and imaging data of all patients treated for incidental aneurysms in our institution between 2000 and 2014.

Results: 397 patients with a sum of 543 aneurysms were included (up to 6 per patients). 277 of the patients (392 aneurysms) primarily underwent surgical and 128 endovascular treatment (150 aneurysms). 9 patients received both endovascular and surgical treatment (multiple aneurysms). 75.5% of the surgical and 69.5% of the endovascular treatment group were female, average age of the surgical group was 52.5 years, resp. 52.7 years for the endovascular patients, BMI and medical history did not significantly differ between both groups. In the surgical group aneurysms tended to have a wider neck (84.6% were rated as “wide necked” in the radiological report, while the same was true for 70.4% of the endovascular treatment group) and a more complex shape (37 versus 18.4%). Further surgically treated aneurysms were more frequently located in the anterior circulation (92% versus 83% of the endovascular treatment group). Incomplete occlusion was observed in 11.2% of the surgically treated aneurysms resp. 28% of the endovascular group. Recurrent aneurysms were observed in 0.7% of the surgical and 2.4% of the endovascular group. Complications included local hematoma (at the wound or puncture site, 9% surgery and 3% endovascular) and other wound healing disorders (9% surgery and 5% endovascular), infections (2% in both groups), local or mayor ischemia on CCT (25, resp. 17%), a transient or permanent neurological deficit (33% surgical group - mostly frontal numbness following supraorbital approach and 23% in the endovascular group), hydrocephalus (3% both groups), mortality rate (1% both groups).

Conclusions: While we observed a certain selection bias, our departmental data showed that surgical treatment for incidental aneurysms did more frequently achieve complete obliteration and recurrent aneurysms were rarer. The risk for postoperative resp. -procedural complications was however slightly higher in the surgical group.