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Is the surgical repair of unruptured atherosclerotic aneurysms at a higher risk of intraoperative ischemia?
MedLine Citation:
PMID:  21095056     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND: The incidence of ischemia might be increased in the surgical repair of atherosclerotic unruptured aneurysms compared to non-atherosclerotic aneurysms. The atherosclerotic wall might increase the occurrence of thrombembolic events or its rigidity might endanger the occlusion of perforators within the aneurysm vicinity.
METHODS: 87 patients (53 patients without and 34 patients with atherosclerotic unruptured aneurysms, 50.5±9.7 years) were analyzed for severity of atherosclerosis within the aneurysm and the aneurysm bearing vessel, surgical maneuvers, intraoperative alterations in evoked potentials and clinical and neuroradiological results.
RESULTS: Temporary vessel occlusion (25% vs. 50%, p=0.021), repositioning of a permanent clip (21% vs. 56%, p=0.001) and aneurysm remnants (2% vs. 18%, p=0.012) occurred more often in patients with atherosclerotic aneurysms. At 6 months, 3/34 patients with atherosclerosis (8.8%) had an unfavorable outcome, all patients without atherosclerosis had a favorable outcome (p=0.056).
CONCLUSION: The surgical repair of unruptured aneurysms is safe but patients with atherosclerotic altered vessels and aneurysms accounted to a minor increase in unfavorable outcome and an increased risk of morbidity at 6 months postoperatively. This factor should be taken into consideration when performing surgery of atherosclerotic, unruptured aneurysms.
Andrea Szelényi; Jürgen Beck; Reinhard Strametz; Stella Blasel; Agi Oszvald; Andreas Raabe; Volker Seifert
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Publication Detail:
Type:  Journal Article     Date:  2010-11-20
Journal Detail:
Title:  Clinical neurology and neurosurgery     Volume:  113     ISSN:  1872-6968     ISO Abbreviation:  Clin Neurol Neurosurg     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7502039     Medline TA:  Clin Neurol Neurosurg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  129-35     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier B.V. All rights reserved.
Department for Neurosurgery, Johann Wolfgang Goethe-University Hospital, Frankfurt, Germany.
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