Prognostic factors influencing outcome in unruptured anterior communicating artery aneurysm after microsurgical clipping

Sudhakar Kasinathan; Yashiro Yamada; Abderrahmane Cheikh; Takao Teranishi; Tsukasa Kawase; Yako Kato

doi:10.4103/ajns.AJNS_198_18

Asian Journal of Neurosurgery, Table of Contents

CC BY-NC-ND 4.0 · Asian J Neurosurg 2019; 14(01): 28-34
DOI: 10.4103/ajns.AJNS_198_18

Review Article

Prognostic factors influencing outcome in unruptured anterior communicating artery aneurysm after microsurgical clipping

Authors

Sudhakar Kasinathan

Department of Neurosurgery, Madras Medical College, Chennai, Tamil Nadu
Yashiro Yamada

¹Department of Neurosurgery, Fujita Health University, Banbuntane Hotokukai Hospital, Nagoya
Abderrahmane Cheikh

²Department of Neurosurgery, Ali Ait Idir Hospital Algiers, Algiers
Takao Teranishi

¹Department of Neurosurgery, Fujita Health University, Banbuntane Hotokukai Hospital, Nagoya
Tsukasa Kawase

¹Department of Neurosurgery, Fujita Health University, Banbuntane Hotokukai Hospital, Nagoya
Yako Kato

¹Department of Neurosurgery, Fujita Health University, Banbuntane Hotokukai Hospital, Nagoya

Abstract

Anterior communicating artery (A.com.A) aneurysm projection is an important factor in determining the outcome of aneurysm clipping. The objective of this study was to analyze the outcome of A.com.A aneurysm projection and prognostic factors influencing it and comparing them with Glasgow outcome scale. A retrospective analysis of 47 patients from hospital records who have got admitted in the Banbuntanke Hotokokai Hospital, Nagoya, Japan, from 2014 to 2017, with unruptured A.com.A aneurysm and subsequently operated in the hospital. Demographic factors such as age, sex, and associated with other aneurysms and the morphological characteristics such as aneurysm size, projection, and height were analyzed with postoperative complications and Glasgow outcome scale. Totally 47 cases have been operated in which 26 (55.3%) are female and 21 (44.6%) are male, and the median age is 68 years, 7 (14.89%) patients had middle cerebral artery aneurysm along with A.com.A aneurysm and 1 had internal carotid artery-posterior communicating artery junction aneurysm. Four (8.5%) had chronic subdural hematoma and 1 (2.12%) had epilepsy, 1 (2.12%) case got reoperated, and 1 (2.12%) had hydrocephalus. Moreover, the overall complication rate is 14.89%. For six patients, motor-evoked potential monitoring was used. Forty-six patients had Glasgow outcome scale of 5 and 1 patient had Glasgow outcome scale of 4. There was no mortality in this study. Mean size of the aneurysm was 6.68 mm and the range was 2–25 mm. Mean height was 4.14 mm, 26 (56.52%) A.com.A aneurysm were anteriorly projecting, 9 (19.56%) were superiorly projecting, 8 (17.32%) were inferiorly projecting, and 3 (6.38%) were posteriorly projecting. Morphological parameters such as size, height, and projection were not only highly associated with A.com.A aneurysm rupture and also complications due to clipping of aneurysm.

Key-words:

Clipping - morphology - outcome - unruptured anterior communicating artery aneurysm

Full Text

References

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