Risk factors and outcomes of postoperative stroke in surgical treatment for giant intracranial aneurysms  

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作  者:Hao Wang Junlin Lu Xin Chen Qiang Hao 

机构地区:[1]Department of Neurosurgery,Fengtai District,Beijing Tiantan Hospital,Capital Medical University,No.119 South Fourth Ring Rd West,Beijing 100070,China [2]Department of Neurosurgery,West China Hospital,Sichuan University,Chengdu,Sichuan,China

出  处:《Chinese Neurosurgical Journal》2023年第2期105-113,共9页中华神经外科杂志(英文)

基  金:supported by National Natural Science Foundation of China(81771234);Beijing Natural Science Foundation of China(7204253);Beijing Municipal Administration of Hospitals Incubating Program,Beijing,China(Grant No.:pX2020023)

摘  要:Background:Giant intracranial aneurysms(GIAs)are challenges for surgical treatment.Risk factors of postoperative stroke remain unclear.This study aims to investigate the predictors of postoperative stroke in GIAs and the impact of stroke on outcomes.Methods:We performed a retrospective medical record review of patients with GIAs who received microsurgery at our institution between 2011 and 2018.Multivariate logistic regression analyses were carried out to identify risk factors for postoperative stroke.The clinical and angiographic outcomes were compared between patients with and without stroke.Results:A total of 97 patients were included in this study.Surgical modalities included direct aneurysm neck clipping in 85 patients(87.7%),trapping with the bypass in 8(8.2%),proximal artery ligation in 1(1%),and bypass alone in 3(3.1%).Postoperative stroke was found in 26 patients(26.8%).Independent factors that affect postoperative stroke were recurrent aneurysm(OR,10.982;95%CI,1.976-61.045;P=0.006)and size≥3.5 cm(OR,3.420;95%CI,1.133-10.327;P=0.029).Combined perioperative mortality and morbidity was 26.8%.Follow-up was achieved from 89 patients(91.8%),with a mean follow-up period of 39 months(range 19 to 94 months).Good outcomes were observed in 75 patients(84.3%)and poor outcomes were observed in 14 patients(15.7%).Conclusions:Postoperative stroke was significantly associated with clinical outcome.Favorable outcomes can be achieved in most patients with GIAs after appropriate microsurgical modality.Recurrent aneurysm and size≥3.5 cm are risk factors of postoperative stroke.

关 键 词:Giant intracranial aneurysms MICROSURGERY OUTCOME STROKE COMPLICATION 

分 类 号:R651.12[医药卫生—外科学]

 

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