Predictors of Atherosclerotic Change in Unruptured Intracranial Aneurysms and Parent Arteries During Clipping

World Neurosurg. 2019 Oct:130:e338-e343. doi: 10.1016/j.wneu.2019.06.084. Epub 2019 Jun 20.

Abstract

Objectives: To identify predictors of atherosclerotic change in aneurysms and parent arteries, and to retrospectively analyze outcomes from clipped aneurysms that showed atherosclerotic changes.

Methods: Between May 2017 and April 2018, we collected a total of 151 clipping cases and reviewed records of operation videos to classify atherosclerosis by location (dome, neck of aneurysm, or parent artery). To identify predictors of atherosclerotic change in aneurysms, we analyzed baseline demographic characteristics, preoperative images, and Framingham Risk Scores (FRS). We also analyzed incomplete clipping cases according to atherosclerosis presence and location.

Result: This study cohort included 110 women (mean age, 59.3 ± 7.1 years) and 41 men (mean age, 55.9 ± 9.6 years). Atherosclerotic change was seen in 77 cases. FRS, diabetes mellitus, and aneurysm size were identified as independent risk factors for atherosclerotic change in multivariate logistic regression analysis. There were 11 incomplete clipping cases (7.2%). Among the 30 cases with atherosclerotic change in the neck were 10 cases of incomplete clipping (P < 0.001).

Conclusions: FRS, diabetes mellitus, and aneurysm size as predictors of atherosclerosis in patients undergoing aneurysm surgery can help guide surgical decisions and performance.

Keywords: Aneurysm; Atherosclerotic change; Clipping aneurysm; Parent artery.

MeSH terms

  • Aged
  • Cerebral Arteries / diagnostic imaging*
  • Cerebral Arteries / surgery
  • Female
  • Humans
  • Intracranial Aneurysm / diagnostic imaging*
  • Intracranial Aneurysm / surgery*
  • Intracranial Arteriosclerosis / diagnostic imaging*
  • Male
  • Middle Aged
  • Monitoring, Intraoperative / methods*
  • Monitoring, Intraoperative / trends
  • Predictive Value of Tests
  • Retrospective Studies
  • Surgical Instruments* / trends