Microsurgical Treatment of 86 Anterior Choroidal Artery Aneurysms: Analysis of Factors Influencing the Prognosis

J Neurol Surg A Cent Eur Neurosurg. 2020 Nov;81(6):501-507. doi: 10.1055/s-0039-3400952. Epub 2020 Jun 19.

Abstract

Purpose: To explore factors affecting the prognosis of choroidal anterior artery aneurysm (AChAA) and provide a reference for improving the postoperative outcome.

Methods: The clinical data of 86 patients with AChAA who underwent treatment by a single surgeon were collected and analyzed retrospectively. Univariate analysis and multivariate logistic regression analysis were conducted to examine 12 factors that possibly affected outcome.

Results: The five factors that affected the patient outcomes were times of subarachnoid hemorrhage (SAH), characteristics of SAH on computed tomography (CT), Hunt-Hess grade, aneurysm size, and presence or absence of postoperative complications. Characteristics of SAH on CT (odds ratio [OR]: 3.727; p = 0.000; 95% confidence interval [CI], 1.850-7.508), aneurysm size (OR: 6.335; p = 0.000; 95% CI, 2.564-15.647), and presence or absence of postoperative complications (OR: 4.141; p = 0.000; 95% CI, 1.995-8.599) were independent risk factors influencing the prognosis. In addition, the incidence of postoperative ischemia (caused by anterior choroidal artery syndrome) is related to the aneurysm emitting part and presence or absence of intraoperative rupture.

Conclusions: The analysis of characteristics of SAH on CT, aneurysm size, and presence or absence of postoperative complications can roughly determine the outcome of patients with AChAAs.

MeSH terms

  • Adult
  • Aged
  • Aneurysm, Ruptured / surgery
  • Cerebral Arteries / surgery*
  • Cerebral Revascularization / methods*
  • Female
  • Humans
  • Intracranial Aneurysm / diagnostic imaging
  • Intracranial Aneurysm / surgery*
  • Ischemia / etiology
  • Ischemia / therapy
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Subarachnoid Hemorrhage / diagnostic imaging
  • Subarachnoid Hemorrhage / surgery*
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Young Adult