TY  - JOUR
A1  - Won, Sae-Yeon
A1  - Seifert, Volker
A1  - Dubinski, Daniel
A1  - Kashefiolasl, Sepide
A1  - Dinc, Nazife
A1  - Bruder, Markus
A1  - Konczalla, Jürgen
T1  - Short- and midterm outcome of ruptured and unruptured intracerebral wide-necked aneurysms with microsurgical treatment
T2  - Scientific reports
N2  - To clip or coil has been matter of debates for several years and is the domain of interdisciplinary decision making. However, the microsurgical outcome has still been elusive concerning wide neck aneurysms (WNA). A retrospective single center study was performed with all patients with ruptured WNA (rWNA) and unruptured WNA (uWNA) admitted to author´s institute between 2007–2017. Microsurgical outcome was evaluated according to Raymond-Roy occlusion grade and follow-up angiography was performed to analyze the stability of neck/aneurysm remnants and retreatment poverty. Of 805 aneurysms, 139 were rWNA (17.3%) and 148 uWNA (18.4%). Complete occlusion was achieved in 102 of 139 rWNA (73.4%) and 112 of 148 uWNA (75.6%). Neck remnants were observed in 36 patients with rWNA (25.9%) and 30 patients with uWNA (20.3%), 1 (0.7%) and 6 (4.1%) patients had aneurysmal remnant, respectively. Overall complication rate was 11.5%. At follow-up (939/1504 months), all remnants were stable except for one, which was further conservatively treated with marginal retreatment rate under 1%. Even the risk of de-novo aneurysm was higher than the risk for remnant growth (2.6% vs 0% in rWNA; 8.7% vs 5.3% in uWNA) without significant difference. Microsurgical clipping is effective for complete occlusion of r/uWNA with low complication. Furthermore, the risk of remnant growth is marginal even lower than the risk of de-novo rate low retreatment rate.
KW  - Neurology
KW  - Outcomes research
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/72221
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-722216
SN  - 2045-2322
N1  - Open Access funding enabled and organized by Projekt DEAL.
VL  - 11.2021
IS  - art. 4982
SP  - 1
EP  - 11
PB  - Macmillan Publishers Limited, part of Springer Nature
CY  - [London]
ER  -