Document Detail

Preliminary observation on predicting the need for coil extraction during microsurgery: the clip-coil ratio.
MedLine Citation:
PMID:  20213931     Owner:  NLM     Status:  MEDLINE    
OBJECT: Coil extraction during microsurgery for recanalized intracranial aneurysms can be associated with high morbidity. We evaluated our preliminary experience using the clip-coil ratio to predict the need for coil extraction. METHODS: A multi-institutional retrospective review of previously coiled aneurysms that were clipped for recurrence between 2005 and 2009 was performed. The maximal height and the widths of the recanalization were measured. The largest of these dimensions was divided by the other. We defined this as the clip-coil ratio, which is a modification of the aspect ratio. RESULTS: Thirteen patients were included in this study. The mean age of the patients was 53 years (range 41-68 years). The aneurysm locations were anterior communicating artery (n = 5), pericallosal artery (n = 2), ophthalmic artery (n = 1), and posterior communicating artery (n = 5). A clip-coil ratio >or=1.3 allowed for microsurgical clipping without coil extraction. The mean ratio in these patients was 1.6. Coil extraction was necessary in two patients with a clip-coil ratio <1.3. CONCLUSION: In reviewing our preliminary experience, we observed that coil extraction during microsurgery was not necessary when the clip coil ratio was >or=1.3. The ratio may serve as an indirect indicator of the amount of aneurysm tissue that can be incorporated within a clip; however, given the small patient population, further studies are needed to validate this concept.
Ketan R Bulsara; Brian Hoh; Charles Rosen; Rokuya Tanikawa; Jeffrey Carpenter
Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Acta neurochirurgica     Volume:  152     ISSN:  0942-0940     ISO Abbreviation:  Acta Neurochir (Wien)     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-08     Completed Date:  2010-06-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0151000     Medline TA:  Acta Neurochir (Wien)     Country:  Austria    
Other Details:
Languages:  eng     Pagination:  431-4     Citation Subset:  IM    
Yale Department of Neurosurgery, Neurovascular Section, New Haven, CT 06520, USA.
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MeSH Terms
Cerebral Angiography
Embolization, Therapeutic / adverse effects*,  instrumentation,  methods
Intracranial Aneurysm / pathology,  radiography,  surgery*
Microsurgery / instrumentation,  methods,  standards
Middle Aged
Outcome Assessment (Health Care)
Postoperative Complications / etiology,  physiopathology,  surgery*
Prostheses and Implants / adverse effects*,  standards
Prosthesis Implantation / adverse effects*,  instrumentation,  methods
Reoperation / methods,  standards*,  statistics & numerical data
Retrospective Studies
Risk Assessment
Surgical Instruments / standards,  statistics & numerical data
Treatment Outcome
Vascular Surgical Procedures / instrumentation,  methods,  standards

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