Universität zu Köln

Goertz, Lukas, Hamisch, Christina, Telentschak, Sergej, Kabbasch, Christoph, von Spreckelsen, Niklas ORCID: 0000-0002-9873-1711, Stavrinou, Pantelis ORCID: 0000-0001-8653-1395, Timmer, Marco, Goldbrunner, Roland, Brinker, Gerrit and Krischek, Boris (2018). Impact of Aneurysm Shape on Intraoperative Rupture During Clipping of Ruptured Intracranial Aneurysms. World Neurosurg., 118. S. E806 - 7. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1878-8769

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Abstract

OBJECTIVE: Irregular shape is a known risk factor of intracranial aneurysm rupture causing subarachnoid hemorrhage. The objective of this study was to determine the impact of aneurysm shape on intraoperative rupture (IOR) during microsurgical clipping of ruptured aneurysms. METHODS: This is a retrospective, single-center study of consecutive patients that underwent clipping between 2010 and 2017. Based on 3-dimensional reconstructions from preoperative computed tomography scan and digital subtraction angiography, aneurysm shape was classified as regular aneurysm (RA) or irregular aneurysm (IRA). Risk factors for IOR were identified using univariate and multivariate statistical analyses. RESULTS: A total of 138 patients with 32 RAs and 102 IRAs were included in the analysis. IRAs had a larger size than RAs (8.3 +/- 3.5 vs. 4.6 +/- 2.3 mm, respectively; P < 0.001). There were 36 instances of IOR (26.1%). The IOR rate was greater in IRAs than in RAs (31.1% vs. 9.4%, respectively; P = 0.02). In multivariate analysis, IRA shape was the only significant independent risk factor for IOR (odds ratio, 3.9; 95% confidence interval, 1.0-14.6; P = 0.047). Unfavorable outcome (modified Rankin scale score greater than 2) was not significantly associated with aneurysm shape (P = 0.998) and IOR (P = 0.260). CONCLUSIONS: Our results demonstrate that IRA shape is an independent risk factor for IOR. In the analyzed patient cohort, aneurysm shape and IOR had no significant impact on patient prognosis.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Goertz, Lukas UNSPECIFIED UNSPECIFIED UNSPECIFIED Hamisch, Christina UNSPECIFIED UNSPECIFIED UNSPECIFIED Telentschak, Sergej UNSPECIFIED UNSPECIFIED UNSPECIFIED Kabbasch, Christoph 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 Goldbrunner, Roland UNSPECIFIED UNSPECIFIED UNSPECIFIED Brinker, Gerrit UNSPECIFIED UNSPECIFIED UNSPECIFIED Krischek, Boris UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-170490
DOI:	10.1016/j.wneu.2018.07.058
Journal or Publication Title:	World Neurosurg.
Volume:	118
Page Range:	S. E806 - 7
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 CEREBRAL-ARTERY BIFURCATION; SURGICAL-TREATMENT; SUBARACHNOID HEMORRHAGE; ENDOVASCULAR TREATMENT; MANAGEMENT; RISK; MORPHOLOGY; SURGERY; COMPLICATIONS; ANGIOGRAPHY Multiple languages Clinical Neurology; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/17049