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Microsurgical clipping of large and giant cerebral aneurysms: a single-center contemporary experience.

Publication ,  Journal Article
Chalouhi, N; Thakkar, V; Tjoumakaris, S; Fernando Gonzalez, L; Hasan, D; Rosenwasser, R; Singhal, S; Jabbour, PM
Published in: J Clin Neurosci
August 2014

Several treatment strategies are available to manage large and giant cerebral aneurysms, including surgical, endovascular and combined approaches. We present our experience with microsurgical clipping of large and giant aneurysms. A total of 138 patients with 139 aneurysms of which 128 were large (≥10mm) and 11 were giant (≥25mm) were treated at our institution between 2004 and 2011. Data were collected from a prospectively maintained neurovascular database. Of 138 patients, 53 (38.4%) patients presented with subarachnoid hemorrhage (SAH). Peri-operative complications occurred in 16.7% of patients causing permanent morbidity in 4.4% and death in 0.7%. Complete occlusion, as evident on intra-operative angiography, was achieved in all clipped aneurysms (100%). Long-term follow-up angiography showed no recurrence (mean follow-up time, 43.9 months; range: 1-72 months). Favorable outcomes at discharge (Glasgow Outcome Scale score 4 or 5) were noted in 64.1% of SAH patients and 93% of non-SAH patients. Favorable outcomes at follow-up (mean follow up time, 42.5 months) were seen in 96% of patients. In our experience, microsurgical clipping of large and giant aneurysms carries low rates of morbidity and mortality with high rates of favorable outcomes. The excellent durability of surgical treatment stands in stark contrast with the high recurrence rates observed with coiling for this subset of aneurysms. These data suggest that microsurgical clipping continues to be a viable option that can be offered for patients with large and giant aneurysms.

Duke Scholars

Published In

J Clin Neurosci

DOI

EISSN

1532-2653

Publication Date

August 2014

Volume

21

Issue

8

Start / End Page

1424 / 1427

Location

Scotland

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Severity of Illness Index
  • Prospective Studies
  • Perioperative Period
  • Neurology & Neurosurgery
  • Middle Aged
  • Microsurgery
  • Male
  • Intracranial Aneurysm
 

Citation

APA
Chicago
ICMJE
MLA
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Chalouhi, N., Thakkar, V., Tjoumakaris, S., Fernando Gonzalez, L., Hasan, D., Rosenwasser, R., … Jabbour, P. M. (2014). Microsurgical clipping of large and giant cerebral aneurysms: a single-center contemporary experience. J Clin Neurosci, 21(8), 1424–1427. https://doi.org/10.1016/j.jocn.2013.11.052
Chalouhi, Nohra, Vismay Thakkar, Stavropoula Tjoumakaris, L. Fernando Gonzalez, David Hasan, Robert Rosenwasser, Saurabh Singhal, and Pascal M. Jabbour. “Microsurgical clipping of large and giant cerebral aneurysms: a single-center contemporary experience.J Clin Neurosci 21, no. 8 (August 2014): 1424–27. https://doi.org/10.1016/j.jocn.2013.11.052.
Chalouhi N, Thakkar V, Tjoumakaris S, Fernando Gonzalez L, Hasan D, Rosenwasser R, et al. Microsurgical clipping of large and giant cerebral aneurysms: a single-center contemporary experience. J Clin Neurosci. 2014 Aug;21(8):1424–7.
Chalouhi, Nohra, et al. “Microsurgical clipping of large and giant cerebral aneurysms: a single-center contemporary experience.J Clin Neurosci, vol. 21, no. 8, Aug. 2014, pp. 1424–27. Pubmed, doi:10.1016/j.jocn.2013.11.052.
Chalouhi N, Thakkar V, Tjoumakaris S, Fernando Gonzalez L, Hasan D, Rosenwasser R, Singhal S, Jabbour PM. Microsurgical clipping of large and giant cerebral aneurysms: a single-center contemporary experience. J Clin Neurosci. 2014 Aug;21(8):1424–1427.
Journal cover image

Published In

J Clin Neurosci

DOI

EISSN

1532-2653

Publication Date

August 2014

Volume

21

Issue

8

Start / End Page

1424 / 1427

Location

Scotland

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Severity of Illness Index
  • Prospective Studies
  • Perioperative Period
  • Neurology & Neurosurgery
  • Middle Aged
  • Microsurgery
  • Male
  • Intracranial Aneurysm