Microsurgical Clipping of Anterior Circle of Willis Aneurysms: A Retrospective Study
Journal Title: Bagcilar Medical Bulletin - Year 2017, Vol 2, Issue 1
Abstract
Objective: The surgical outcomes of anterior circle of Willis aneurysms were evaluated. Material and Methods: Between March 2015 and December 2016, 38 patients were operated and followed up for aneurysms. There were 15 female and 23 male patients with a mean age of 47 years (range: 17-78). Of the patients, 35 were diagnosed with subarachnoid hemorrhage (SAH). Of these patients, 54.2% (n=19) were operated within the first 24 hours. All patients were operated by the same surgeon with sylvian dissection. All clinical data in the hospital charts and outpatient records and radiological investigations stored in the archive were evaluated retrospectively. Results: The most commonly seen aneurysm was on the anterior communicating artery (44.8%). After that, aneurysms on the middle cerebral artery (31.6%), posterior communicating artery (13.2%), internal cerebral artery bifurcation (7.8%), and distal anterior cerebral artery were seen, respectively. There was a significant correlation between the location of the aneurysm and the mean age (p=0.009). All patients were followed in the intensive care unit after operation. After surgery, vasospasm was observed in 26.3% of patients. Patients with high SAH grade developed vasospasm significantly more frequently (p=0.03). Neurological examinations at discharge were normal in 17 patients with SAH and 3 patients without SAH. Four patients were discharged with minimal neurological deficit and 2 patients with severe deficit. Eight patients with World Federation of Neurosurgical Societies (WFNS) grade 4-5, 2 patients with grade 3, and 2 patients with grade 1-2 were lost. Postoperative Glasgow Coma Scale and SAH WFNS grades were found to be determinants for dying. Conclusion: Despite the development of endovascular techniques in the treatment of aneurysm, microsurgical clipping remains the first choice method to treat anterior system aneurysms. Closure of the aneurysm is the treatment priority. It is well known that early surgery reduces mortality and morbidity.
Authors and Affiliations
Burak Eren, Feyza Karagoz Guzey, Murat Yucel, Ozgur Yusuf Aktas, Abdurrahim Tas, Azmi Tufan, Mustafa Safi Vatansever, Ilker Gulec, Ebru Doruk, Mustafa Ornek
Keywords
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- EP ID EP50389
- DOI 10.5350/BMB20170218032850
- Views 225
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