Document Detail

Efficacy of clip-wrapping in treatment of complex pediatric aneurysms.
MedLine Citation:
PMID:  22895680     Owner:  NLM     Status:  Publisher    
PURPOSE: Pediatric aneurysms (PAs) are distinct from their adult counterparts with respect to typical location, aneurysm type, and known predisposing risk factors. Many strategies have been employed to treat PAs, but although it has been used frequently in adults, clip wrapping in pediatric patients has only been reported once. We present a series of pediatric patients that underwent clip wrapping and discuss this strategy as an effective means of treating unclippable PAs. METHODS: Pediatric patients with clip-wrapped aneurysms over a 5-year period were retrospectively identified. Clinical presentation, surgical management, and clinical and radiological outcome of the patients were evaluated. RESULTS: Five pediatric patients with aneurysms were treated with clip wrapping during the specified period. Three had traumatic pseudoaneurysms, with two subarachnoid hemorrhages from aneurysm rupture. One patient presented with mycotic pseudoaneurysm rupture causing a large intraparenchymal and subarachnoid hemorrhage. Another patient had a dissecting complex saccular lenticulostriate aneurysm with four perforating vessels arising from the dome. Four patients had good clinical results, with Glasgow Outcome Scale (GOS) scores of 5 after at least 1-year follow-up (mean 24.2); one patient had a GOS score of 5 at discharge, but no additional follow-up. Postoperative neuroimaging demonstrated vessel patency after clip wrapping with no recurrent hemorrhages or increase in aneurysm size; however, one had progressive occlusion of the artery in a delayed fashion and had a small clinical ischemic event from which she fully recovered. CONCLUSIONS: Clip wrapping appears to be an effective underutilized technique for treatment of pediatric complex aneurysms that cannot be treated with conventional methods.
Christian Bowers; Jay Riva-Cambrin; William T Couldwell
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-16
Journal Detail:
Title:  Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery     Volume:  -     ISSN:  1433-0350     ISO Abbreviation:  Childs Nerv Syst     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8503227     Medline TA:  Childs Nerv Syst     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, 175 N. Medical Drive East, Salt Lake City, UT, 84132, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Microsurgical outlet restoration in isolated fourth ventricular hydrocephalus: a single-institutiona...
Next Document:  Use of magnetic resonance imaging to identify the edge of a dural tear in an infant with growing sku...