机构:[1]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurosurg, Beijing, Peoples R China;重点科室诊疗科室神经外科神经外科首都医科大学附属天坛医院[2]China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China;国家神经系统疾病临床医学研究中心国家神经系统疾病临床医学研究中心首都医科大学附属天坛医院[3]Beijing Inst Brain Disorders, Ctr Stroke, Beijing, Peoples R China;[4]Beijing Key Lab Translat Med Cerebrovasc Dis, Beijing, Peoples R China;[5]Capital Med Univ, Beijing, Peoples R China;[6]Univ Calif San Francisco, Dept Neurol Surg, San Francisco, CA USA;[7]Binzhou Med Univ, Affiliated Hosp, Dept Neurosurg, Binzhou, Shandong, Peoples R China
INTRODUCTION: The rupture rate of unruptured intracranial aneurysms is influenced by certain angioarchitectural and hemodynamic characteristics. Recently the translucent appearance of aneurysms was described as a possible risk factor for aneurysm rupture. In this study, we investigate the intraoperative rupture risk of surgically clipped unruptured translucent aneurysms (TAs). METHOD: Clinical and radiologic data of micro-surgically treated unruptured middle cerebral artery (MCA) bifurcation aneurysms between 2013 and 2015 were collected and analyzed. Aneurysms were divided into TA as defined as >90% reddish pigmentation appearance of the aneurysm wall or non-TA (NTA) according to the observation under microscope by a single neurosurgeon. Parameters were analyzed using univariate and multivariate statistical analyses. RESULT: A total of 41 unruptured MCA bifurcation aneurysms were included in the analysis, and 68.2% (28/41) were defined as TA. The univariate analysis showed that aneurysm characteristics (Dmax, Wmax, height, and lower size ratio [SR]) that were small in nature were associated with TAs. TAs were associated with intraoperative rupture (28.6% vs. 0%, P = 0.04). Multivariate logistic regression analysis found that the lower SR is the independent risk factor for TAs. CONCLUSION: The results demonstrate that a lower SR correlates with TA in the MCA bifurcation and the thinner wall of the TA causes intraoperative rupture more likely. These results provide important information on the fragility of TAs and might influence the treatment decisions in unruptured MCA bifurcation aneurysms with lower SRs.
基金:
Ministry of Science and Technology of ChinaMinistry of Science and Technology, China; National Key Technology Research and Development ProgramNational Key Technology R&D Program [2015BAI12B04, 2013BAI09B03, 2012CB720704]; Beijing Institute for Brain Disorders grant [BIBD-PXM2013_ 014226_07_000084]; National Natural Science Foundation of ChinaNational Natural Science Foundation of China [H0906 81271313, H0906 81571110, 81500995]