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Translucent Appearance of Middle Cerebral Artery Bifurcation Aneurysms Is Risk Factor for Intraoperative Aneurysm Rupture During Clipping

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机构: [1]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurosurg, Beijing, Peoples R China; [2]China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China; [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
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关键词: MCA bifurcation aneurysm Risk factor Size ratio Translucent aneurysm

摘要:
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.

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出版当年[2016]版:
大类 | 3 区 医学
小类 | 3 区 临床神经病学 3 区 外科
最新[2023]版:
大类 | 4 区 医学
小类 | 4 区 临床神经病学 4 区 外科
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出版当年[2015]版:
Q1 SURGERY Q2 CLINICAL NEUROLOGY
最新[2023]版:
Q2 SURGERY Q3 CLINICAL NEUROLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2015版] 出版当年五年平均 出版前一年[2014版] 出版后一年[2016版]

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第一作者机构: [1]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurosurg, Beijing, Peoples R China; [2]China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China; [3]Beijing Inst Brain Disorders, Ctr Stroke, Beijing, Peoples R China; [4]Beijing Key Lab Translat Med Cerebrovasc Dis, Beijing, Peoples R China;
通讯作者:
通讯机构: [1]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurosurg, Beijing, Peoples R China; [2]China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China; [3]Beijing Inst Brain Disorders, Ctr Stroke, Beijing, Peoples R China; [4]Beijing Key Lab Translat Med Cerebrovasc Dis, Beijing, Peoples R China;
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