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Residual lesions in patients undergoing microsurgical clipping of cerebral aneurysms in a reference university hospital
Aguiar, Guilherme Brasileiro de; Kormanski, Matheus Kohama; Corrêa, Carolina Junqueira Tavares; Batista, Andrew Vinícius de Souza; Conti, Mario Luiz Marques; Veiga, José Carlos Esteves.
  • Aguiar, Guilherme Brasileiro de; Faculdade de Ciencias Medicas da Santa Casa de Sao Paulo (FMSCSP). BR
  • Kormanski, Matheus Kohama; Faculdade de Ciencias Medicas da Santa Casa de Sao Paulo (FMSCSP). BR
  • Corrêa, Carolina Junqueira Tavares; Faculdade de Ciencias Medicas da Santa Casa de Sao Paulo (FMSCSP). BR
  • Batista, Andrew Vinícius de Souza; Faculdade de Ciencias Medicas da Santa Casa de Sao Paulo (FMSCSP). BR
  • Conti, Mario Luiz Marques; Faculdade de Ciencias Medicas da Santa Casa de Sao Paulo (FMSCSP). BR
  • Veiga, José Carlos Esteves; Faculdade de Ciencias Medicas da Santa Casa de Sao Paulo (FMSCSP). BR
Clinics ; 75: e1973, 2020. tab
Article in English | LILACS | ID: biblio-1133348
ABSTRACT

OBJECTIVES:

This study aimed to analyze the incidence and epidemiological, angiographic, and surgical aspects associated with incomplete clipping of brain aneurysms in a cohort of patients undergoing microsurgical treatment.

METHODS:

The medical record data of patients who underwent microsurgery for cerebral aneurysm treatment and postoperative digital subtraction angiography, treated at the same teaching hospital between 2014 and 2019, were retrospectively analyzed. The studied variables involved epidemiological and clinical data, as well as neurological status and findings on neuroimaging. The time elapsed between hemorrhage and microsurgical treatment, data on the neurosurgical procedure employed for aneurysm occlusion, and factors associated with the treated aneurysm, specifically location and size, were also evaluated.

RESULTS:

One hundred and seventeen patients were submitted to 139 neurosurgical procedures, in which 167 aneurysms were clipped. The overall rate of residual injury was 23%. Smoking (odds ratio [OR] 3.38, 95% confidence interval [CI95%] 1.372-8.300, p=0.008), lesion size >10 mm (OR 5.136, CI95% 2.240-11.779, p<0.001) and surgery duration >6 h (OR 8.667, CI95% 2.713-27.681, p<0.001) were found to significantly impact incomplete aneurysm occlusion in the univariate analyses.

CONCLUSION:

Incomplete microsurgical aneurysm occlusion is associated with aneurysm size, complexity, and current smoking status. Currently, there is no consensus on postoperative assessment of clipped aneurysms, hindering the correct assessment of treatment outcomes.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Intracranial Aneurysm / Aneurysm, Ruptured Type of study: Observational study / Risk factors Limits: Humans Language: English Journal: Clinics Journal subject: Medicine Year: 2020 Type: Article Affiliation country: Brazil Institution/Affiliation country: Faculdade de Ciencias Medicas da Santa Casa de Sao Paulo (FMSCSP)/BR

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Full text: Available Index: LILACS (Americas) Main subject: Intracranial Aneurysm / Aneurysm, Ruptured Type of study: Observational study / Risk factors Limits: Humans Language: English Journal: Clinics Journal subject: Medicine Year: 2020 Type: Article Affiliation country: Brazil Institution/Affiliation country: Faculdade de Ciencias Medicas da Santa Casa de Sao Paulo (FMSCSP)/BR