Document Detail


Ruptured intracranial aneurysms with small basal outpouching: incidence of basal rupture and results of surgical and endovascular treatments.
MedLine Citation:
PMID:  22895399     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Recognizing an aneurysmal basal rupture using angiographic evaluation is crucial for optimal treatment.
OBJECTIVE: To evaluate the incidence of a small basal outpouching (the most common angiographic configuration suggesting a basal rupture), the incidence of a ruptured basal outpouching, and the results of surgical and endovascular treatments.
METHODS: The occurrence of small basal outpouchings was determined in the initial angiographic examinations of 471 patients with a ruptured aneurysm. Information was also obtained from patient charts, surgical and interventional reports, operative video records, and reviews of radiological investigations.
RESULTS: A small basal outpouching was identified in 41 (8.7%) of the 471 ruptured aneurysms. In the surgical series (n = 286), a basal rupture was identified in 8 (30.8%) of the 26 cases of a basal outpouching and successfully treated by aneurysm clip placement. In the endovascular series (n = 185), intraprocedural aneurysm rebleeding developed in 5 of the 15 patients (33.3%) with a basal outpouching, which was most commonly observed with anterior communicating artery aneurysms.
CONCLUSION: The current surgical series included a 9% incidence of ruptured intracranial aneurysms with a small basal outpouching, and a 31% incidence of these basal outpouchings being identified as the rupture point. The results also suggested that endovascular coiling of a basal outpouching carries a high risk of intraprocedural aneurysm rebleeding, whereas surgical clipping is safer and provides more protection against rebleeding of aneurysms with a basal rupture.
Authors:
Jaechan Park; Hyunjin Woo; Dong-Hun Kang; Yongsun Kim; Seung Kug Baik
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Neurosurgery     Volume:  71     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-10-19     Completed Date:  2013-05-17     Revised Date:  2013-08-13    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  994-1001; discussion 1002     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Kyungpook National University, Daegu, Republic of Korea. jparkneurosurgery@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aneurysm, Ruptured / complications,  diagnosis,  surgery*
Cerebral Angiography
Embolization, Therapeutic / methods*
Female
Follow-Up Studies
Humans
Imaging, Three-Dimensional
Incidence
Intracranial Aneurysm / complications,  diagnosis,  surgery*
Male
Middle Aged
Tomography, X-Ray Computed
Treatment Outcome
Video Recording
Comments/Corrections
Comment In:
Neurosurgery. 2013 Jul;73(1):E193-4   [PMID:  23615111 ]
Neurosurgery. 2013 Jul;73(1):E192-3   [PMID:  23615107 ]

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


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