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Microsurgical clipping of unruptured middle cerebral artery bifurcation aneurysms: incidence of and risk factors for procedure-related complications.

Chung, J | Hong, CK | Shim, YS | Joo, JY | Lim, YC  | Shin, YS | Kim, YB
World neurosurgery, 83(5). : 666-672, 2015
Journal Title
World neurosurgery
OBJECTIVE: To report our experiences in microsurgical clipping of unruptured middle cerebral artery (MCA) bifurcation aneurysms and to evaluate the incidence of and risk factors for procedure-related complications.

METHODS: The study comprised 416 patients treated between March 2003 and February 2014. All patients met the following criteria: 1) microsurgical clipping of an unruptured MCA bifurcation aneurysm was performed, and 2) clinical and radiographic follow-up data were available including preoperative digital subtraction angiography. The incidence of and risk factors for procedure-related complications were retrospectively evaluated.

RESULTS: Procedure-related complications occurred in 15 (3.6%) patients, including asymptomatic complications in 10 (2.4%) patients and symptomatic complications in 5 (1.2%) patients. Multivariate logistic regression analysis showed that posteroinferior projection of the aneurysm (odds ratio = 2.814, 95% confidence interval = 0.995-6.471, P = 0.042), distance between the internal carotid artery bifurcation and the MCA bifurcation (Dt) in a linear line (odds ratio = 1.813, 95% confidence interval = 0.808-6.173, P = 0.043), and horizontal angle between the vertical line to the base of the skull and Dt (odds ratio = 2.046, 95% confidence interval = 1.048-10.822, P = 0.048) were independent risk factors for procedure-related complications.

CONCLUSIONS: When performing clipping of unruptured MCA bifurcation aneurysms, the procedure-related complication rate was 3.6%. Patients with MCA bifurcation aneurysms with posteroinferior projection, shorter Dt, and larger horizontal angle may be at a higher risk of procedure-related complications when performing microsurgical clipping.

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Journal Papers > School of Medicine / Graduate School of Medicine > Neurosurgery
Ajou Authors
임, 용철
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