Analysis of Clip-induced Ischemic Complication of Anterior Choroidal Artery Aneurysms.
10.3340/jkns.2008.43.3.131
- Author:
Min Soo CHO
1
;
Min Su KIM
;
Chul Hoon CHANG
;
Sang Woo KIM
;
Seong Ho KIM
;
Byung Yon CHOI
Author Information
1. Department of Neurosurgery, College of Medicine, Yeungnam University, Daegu, Korea. bychoi@med.yu.ac.kr
- Publication Type:Original Article
- Keywords:
Anterior choroidal artery infarction;
Clip;
Intracranial aneurysm
- MeSH:
Adenosine;
Aneurysm;
Aneurysm, Ruptured;
Arteries;
Brain;
Carotid Artery, Internal;
Cerebral Infarction;
Choroid;
Decision Making;
Intracranial Aneurysm;
Neck;
Retrospective Studies;
Stroke;
Surgical Instruments
- From:Journal of Korean Neurosurgical Society
2008;43(3):131-134
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: The surgical approach is typically similar to those used for other supraclinoid internal carotid artery (ICA) lesions. However, the surgical clipping of this aneurysm is complicated and as a result, can result in postoperative ischemic complications. We studied to clarify the clip-induced ischemic complication risk of AChA aneurysm and to get the benefits for helping decision making. METHODS: We retrospectively investigated 53 cases (4.0%) of AchA aneurysm treated surgically. We divided the AChA aneurysm to 3 subtype according to the origin of aneurysmal neck; A type originating from the AChA itself, J type from junction of AChA and ICA, and I type from the ICA itself. We evaluated brain CT about 1 week post-operative day to confirm the low density in AChA territory. RESULTS: Ruptured aneurysm was 26 cases and unruptured aneurysm 27 cases. The aneurysmal subtype of A, J, and I was 13, 17, and 23 cases. Of the 53 cases who performed surgical neck clipping, twelve (22.6%) had postoperative AChA distribution infarcts. Increased infarct after neck clipping had statistic significance in non-I subtype (p=0.005). CONCLUSION: It is easy to classify as "easy" surgery. But surgery for AChA aneurysms carries with it a significant risk of postoperative stroke. Don't always stick to clipping only, especially in non-I type of incidental small aneurysm, which has high risk of post-clip ischemic complications.
