selective clipping microsurgical treatment for multiple intracranial anterior circulation aneurysms

ABSTRACT

To summarize our experiences with selective clipping microsurgical treatment and prognoses of 146 cases of intracranial multiple anterior circulation aneurysms. Non-concurrent cohort study. Department of Neurosurgery, first Hospital of Jilin University, Changchun, China. One hundred and forty-six patients with intracranial multiple anterior circulation aneurysms who underwent surgical clipping. These aneurysms in each patient were given selective treatment depending on whether the patients were symptomatic, or had likelihood of rupture if they were asymptomatic. Glasgow outcome scale [GOS] was applied to assess the patients' condition. Among 146 patients, they were 169 asymptomatic and 146 symptomatic aneurysms. Symptomatic aneurysms included 139 ruptured and seven uruptured aneurysms All symptomatic aneurysms were clipped, and asymptomatic aneurysms were treated selectively. A postsurgical GOS of grade 5 was found in 136 cases, grade 4 in 6 cases, grade 3 in 1 case, and grade 1 [death] occurred in 3 cases. At postsurgical follow-up, computed tomography angiography [CTA] revealed completed clipping of all symptomatic aneurysms and no changes in the asymptomatic. Apart from the three cases in which death occurred during hospitalization, we followed up a total of 128 of the remaining 143 cases between 5 and 10 years. The post-surgical mortality rate was 2.1%. Follow-up GOS scores were grade 5 in 123 patients [96.1%], grade 4 [3.1%] in four and grade 3 in one [0.8%]. Satisfactory prognoses were achieved in the selective treatment of intracranial multiple anterior circulation aneurysms