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Clipping of very large or giant unruptured intracranial aneurysms in the anterior circulation: an outcome study.

Publication ,  Journal Article
Hauck, EF; Wohlfeld, B; Welch, BG; White, JA; Samson, D
Published in: J Neurosurg
December 2008

OBJECT: Patients with very large or giant unruptured intracranial aneurysms present with ischemic stroke and progressive disability. The aneurysm rupture risk in these patients is extreme-up to 50% in 5 years. In this study the authors investigated the outcome of surgical treatment for these very large aneurysms in the anterior circulation. METHODS Clinical data on 62 patients who underwent surgery for unruptured aneurysms (20-60 mm) between 1998 and 2006 were reviewed. RESULTS: Complete aneurysm occlusion (100%) was achieved in 90% of cases, near complete occlusion (90-99%) in 5%. The surgical risk in patients younger than 50 years of age was 8% (Glasgow Outcome Scale score of 1 or 3 within 1 year after surgery). In older patients, the risk increased with advancing age. CONCLUSIONS: The treatment of very large or giant unruptured intracranial aneurysms is hazardous and complex and thus best performed only at major cerebrovascular centers with an experienced team of neurosurgeons, interventional neuroradiologists, neurologists, and neuroanesthesiologists. Surgery, with acceptable risks and excellent occlusion rates, is typically the treatment of choice in patients younger than 50 years of age. In older patients, the benefits of endovascular treatment versus surgery versus no treatment must be carefully weighed individually. Minimizing temporary occlusion and the consequent use of intraoperative angiography may help reduce surgical complications.

Duke Scholars

Published In

J Neurosurg

DOI

ISSN

0022-3085

Publication Date

December 2008

Volume

109

Issue

6

Start / End Page

1012 / 1018

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Surgical Instruments
  • Risk Factors
  • Retrospective Studies
  • Neurosurgical Procedures
  • Neurology & Neurosurgery
  • Multivariate Analysis
  • Middle Aged
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Hauck, E. F., Wohlfeld, B., Welch, B. G., White, J. A., & Samson, D. (2008). Clipping of very large or giant unruptured intracranial aneurysms in the anterior circulation: an outcome study. J Neurosurg, 109(6), 1012–1018. https://doi.org/10.3171/JNS.2008.109.12.1012
Hauck, Erik F., Bryan Wohlfeld, Babu Guai Welch, Jonathan A. White, and Duke Samson. “Clipping of very large or giant unruptured intracranial aneurysms in the anterior circulation: an outcome study.J Neurosurg 109, no. 6 (December 2008): 1012–18. https://doi.org/10.3171/JNS.2008.109.12.1012.
Hauck EF, Wohlfeld B, Welch BG, White JA, Samson D. Clipping of very large or giant unruptured intracranial aneurysms in the anterior circulation: an outcome study. J Neurosurg. 2008 Dec;109(6):1012–8.
Hauck, Erik F., et al. “Clipping of very large or giant unruptured intracranial aneurysms in the anterior circulation: an outcome study.J Neurosurg, vol. 109, no. 6, Dec. 2008, pp. 1012–18. Pubmed, doi:10.3171/JNS.2008.109.12.1012.
Hauck EF, Wohlfeld B, Welch BG, White JA, Samson D. Clipping of very large or giant unruptured intracranial aneurysms in the anterior circulation: an outcome study. J Neurosurg. 2008 Dec;109(6):1012–1018.

Published In

J Neurosurg

DOI

ISSN

0022-3085

Publication Date

December 2008

Volume

109

Issue

6

Start / End Page

1012 / 1018

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Surgical Instruments
  • Risk Factors
  • Retrospective Studies
  • Neurosurgical Procedures
  • Neurology & Neurosurgery
  • Multivariate Analysis
  • Middle Aged
  • Male