Intraoperative rupture in the surgical treatment of patients with intracranial aneurysms

Chen, S.F.; Kato, Yoshihiro; Kumar, Ashish; Tan, Guowei; Oguri, Daikichi; Oda, Jumpei; Watabe, Takeya; Imizu, Shuei; Sano, Hirotoshi; Wang, Z.X.

doi:10.1016/j.jocn.2016.01.045

Cited by 33 publications

(33 citation statements)

References 19 publications

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“…Generally, IAR has been shown to increase the risk of unfavorable outcome in well-powered microsurgical series. [46][47][48][49][50] Our series found that cases of IAR had a statistically insignificant increased likelihood of unfavorable outcome. It is possible that our series was underpowered to show worse outcomes in IAR cases.…”

Section: Iar Temporary Clipping Strategy and Brain Infarctionmentioning

confidence: 57%

Simple Lateral Suboccipital Approach and Modification for Vertebral Artery Aneurysms: A Study of 52 Cases Over 10 Years

et al. 2017

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Section: Iar Temporary Clipping Strategy and Brain Infarctionmentioning

confidence: 57%

Simple Lateral Suboccipital Approach and Modification for Vertebral Artery Aneurysms: A Study of 52 Cases Over 10 Years

et al. 2017

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“…За д аними лі терат ури [9,10], кон так т ні ІОРА трапляються в 91-94 % спостережень, неконтактні ІОРА -у 2,5-9,0 %. Основними критеріями та чинниками ризику, які впливають на частоту ІОРА, вважають розмір аневризми, її локалізацію, форму, термін проведення операції після первинного розриву аневризми, наявність гіпертонічної хвороби і тяжкість стану хворого до операції [11][12][13][14][15][16][17][18].…”

Section: Discussionunclassified

“…Тяжкість стану хворого до операції. За даними більшості авторів, частота виникнення ІОРА вище у хворих з тяжкістю стану IV-V ступеня за шкалою Hunt-Hess [18,21]. Однак J. Schramm і С. Cedzich (1993), P.D.…”

Section: Discussionunclassified

Intraoperative aneurysm rupture — the main complication in microsurgery of cerebral aneurysms

Byndiu¹,

Orlov²,

Yeleynik³

et al. 2019

Ukr Neurosurg J

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“…To date, a clear relationship between IORA and the severity of the patient before surgery has not been established. Some authors indicate that the incidence of IORA is higher in patients with severity of IV-V degree according to the Hunt-Hess scale [18,21] Time of surgery after a primary AA rupture. Surgery in the early stages after the primary rupture of the aneurysm, in the presence of cerebral edema, with difficulty in accessing AA, the need to perform sufficient traction of the cerebral substance is often accompanied by IORA [5,7,11,12,15,11].…”

Section: Aneurysm Surgerymentioning

confidence: 99%

Risk factors and clinical and neurological consequences of intraoperative rupture of brain aneurysms in microsurgical operations

Bindu¹,

Yu.²,

Литвак³

et al. 2020

roneuro

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Objective. to assess the frequency, risk factors and clinical and neurological consequences of intraoperative rupture of arterial aneurysm (AA) of the brain (B) in clipping operations of the B AA . Materials and approaches. A retrospective analysis of microsurgical operations clipping of cerebral aneurysms in 1449 (100%) patients for the period from 2011 to 2018 was performed, of which 141 (9.73%) cases had intraoperative rupture of the aneurysm (IORA). Preoperative examination: clinical and neurological examination, CT of the brain, cerebral angiography( CAG), duplex scanning of the main vessels of the head and neck. The analyzed criteria are risk factors of IORA: AA size, localization, shape, duration of surgery after the primary rupture of AA, the presence of hypertension and the patient's condition before surgery. Results. The frequency of IORA in clipping operations of B AA was 9.73% (141 patients) in a series of observations 1441 (100%). Most often IORA-141 (100%) was registered in clipping operations of AA of complex ACA-AcomA (86 (61%) cases out of 141 (100%)). IORA is possible at all stages of the operation with the maximum frequency of contact breaks – 135 (95.74%); the rarest-6 ( 4.26%) - non - contact IORA (at the stage of craniotomy) was recorded. At the preoperative stage, the vast majority of patients with subsequent IORA were diagnosed with cerebral edema, AA of large size, atherosclerotic changes in the aneurysm-affected segment of the artery and cervical areas of the aneurysm, high blood pressure during surgery, adhesive arachnoid changes. At the time of discharge from the hospital, according to the Glasgow results scale: 69 (48.94%) full or partial restoration of labor activity, 18 (12.77%) had limited daily activities without the need for outside assistance, 37 (26 24%) deep disability ) Deaths were in the group of "contact" IORA - 17 (12.06%). At 6 ( 4.26%) of "non-contact" IORA, a deepening of initial neurological symptoms was recorded with a suppression of the level of consciousness, the addition of pyramidal insufficiency, speech impairment and psycho-organic syndrome, and a deepening of the phenomena of initial cerebral arterial vasospasm. Conclusions. IORA is predominantly in contact with a frequency of occurrence-9.73 %. The most common risk factors for IORA were: cerebral edema, large AA, atherosclerotic changes in the aneurysm-affected artery segment and cervical aneurysm sites, high blood pressure during surgery, adhesions arachnoid changes. IORA leads to deepening of initial neurological symptoms, phenomena of initial vasospasm of cerebral arteries with the level of total mortality-17 (12.06%).

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Intraoperative rupture in the surgical treatment of patients with intracranial aneurysms

Cited by 33 publications

References 19 publications

Simple Lateral Suboccipital Approach and Modification for Vertebral Artery Aneurysms: A Study of 52 Cases Over 10 Years

Simple Lateral Suboccipital Approach and Modification for Vertebral Artery Aneurysms: A Study of 52 Cases Over 10 Years

Intraoperative aneurysm rupture — the main complication in microsurgery of cerebral aneurysms

Risk factors and clinical and neurological consequences of intraoperative rupture of brain aneurysms in microsurgical operations

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