Impact of the different rupture points on the prognosis of patients in anterior circulation aneurysm clipping / 中国脑血管病杂志

ABSTRACT

Objective Toinvestigatetheimpactofthedifferentrupturepoints(sac,neck,andtop) of intraoperative aneurysm rupture (IAR)on the prognosis of patients in anterior circulation aneurysm clipping.Methods Theclinicaldataof135consecutivepatients(148aneurysms)acceptedmicrosurgical aneurysm clipping from May 2009 to March 2012 were analyzed retrospectively. The prognostic evaluation of the patients after procedure was assessed by using the Glasgow outcome scale (GOS). The different aneurysm rupture points of IAR were used as influencing factors,and the relationship between the different rupture pointsandtheprognosisofpatientswasanalyzed.Results Duringclippingof148aneurysmsin 135 patients,31 aneurysms in 30 patients had intraoperative rupture (20. 9% of the aneurysms, 22.2% of the patients). Nine rupture points occurred on the top of aneurysms,17 occurred on the sac,and 5 occurred on neck. The Glasgow outcome scale (GOS)scores 5,4,3,2 and 1 were in 17,8,2,1 and 2 patients,respectively. A total of 25 patients had good prognosis and 5 cases had poor prognosis. There were no significant differences in the impact of different rupture points of IAR on the prognosis in patients of IAR (OR,100. 00,95% confidence interval 6. 764-18. 344,P=0. 006). Of the 25 patients with aneurysm sac or top rupture,1 case had poor prognosis. Of the 5 patients with aneurysm neck rupture, 4caseshadpoorprognosis.Conclusion Inanteriorcirculationaneurysmclipping,thedifferent aneurysm rupture points may have significant impact on the prognosis of patients,the aneurysm neck rupture is a main factor for resulting in the poor prognosis of patients.