Universität zu Köln

Goertz, Lukas, Kabbasch, Christoph, Borggrefe, Jan ORCID: 0000-0003-2908-7560, Hamisch, Christina, Telentschak, Sergej, von Spreckelsen, Niklas ORCID: 0000-0002-9873-1711, Stavrinou, Pantelis ORCID: 0000-0001-8653-1395, Timmer, Marco, Brinker, Gerrit, Goldbrunner, Roland and Krischek, Boris (2018). Preoperative Three-Dimensional Angiography May Reduce Ischemic Complications During Clipping of Ruptured Intracranial Aneurysms. World Neurosurg., 120. S. E1163 - 8. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1878-8769

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Abstract

OBJECTIVE: Microsurgical clipping ut aneurysms demands precise spatial understanding of aneurysm morphology and vascular geometry. We analyzed the impact of preoperative three-dimensional (3D) angiographic imaging on clinical and angiographic outcome after clipping of ruptured intracranial aneurysms. METHODS: This is a retrospective analysis of consecutive patients who underwent microsurgical clipping during the acute phase of subarachnoid hemorrhage between 2010 and 2017. Surgical planning was made based on two-dimensional (2D) or 3D angiographic images. We retrospectively compared complication rates, morbidity, and angiographic outcome between these 2 groups. RESULTS: A total of 157 patients (mean age: 54.8 +/- 13.1 years) were included in the study. Preoperative 3D angiographic imaging was available for 117 cases. The rate of procedure-related ischemia was significantly lower in the 3D group (16.2%) than in the 2D group (35.0%; P = 0.013). In the multivariate analysis, 2D imaging alone remained as independent factor for subsequent brain ischemia (odds ratio: 2.8, 95% confidence interval 1.2-6.6; P = 0.018). Favorable outcome (modified Rankin scale <= 2) was more often attained in the 3D group (70.0%) than in the 2D group (41.9%; P = 0.002). The rate of complete aneurysm occlusion was not significantly different between the 2 groups (P = 0.967). CONCLUSIONS: In our study, accurate operation planning using 3D angiography was associated with a lower ischemic complication rate after clipping of ruptured intracranial aneurysms, which may potentially influence clinical outcome.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Goertz, Lukas UNSPECIFIED UNSPECIFIED UNSPECIFIED Kabbasch, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Borggrefe, Jan UNSPECIFIED orcid.org/0000-0003-2908-7560 UNSPECIFIED Hamisch, Christina UNSPECIFIED UNSPECIFIED UNSPECIFIED Telentschak, Sergej UNSPECIFIED UNSPECIFIED UNSPECIFIED von Spreckelsen, Niklas UNSPECIFIED orcid.org/0000-0002-9873-1711 UNSPECIFIED Stavrinou, Pantelis UNSPECIFIED orcid.org/0000-0001-8653-1395 UNSPECIFIED Timmer, Marco UNSPECIFIED UNSPECIFIED UNSPECIFIED Brinker, Gerrit UNSPECIFIED UNSPECIFIED UNSPECIFIED Goldbrunner, Roland UNSPECIFIED UNSPECIFIED UNSPECIFIED Krischek, Boris UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-164511
DOI:	10.1016/j.wneu.2018.09.026
Journal or Publication Title:	World Neurosurg.
Volume:	120
Page Range:	S. E1163 - 8
Date:	2018
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1878-8769
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DIGITAL-SUBTRACTION-ANGIOGRAPHY; ROTATIONAL ANGIOGRAPHY; ENDOVASCULAR COILING; ARTERY ANEURYSMS; DOPPLER; TRIAL; ISAT Multiple languages Clinical Neurology; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/16451