Changes in volume of giant intracranial aneurysms treated by surgical strategies other than direct clipping

• Published in: Acta neurochirurgica 2015-07, Vol.157 (7), p.1117-1123
• Main Authors: Maldaner, Nicolai, Guhl, Susanne, Mielke, Dorothee, Musahl, Christian, Schmidt, Nils Ole, Wostrack, Maria, Rüfenacht, Daniel A., Vajkoczy, Peter, Dengler, Julius
• Format: Article
• Language: English
• Subjects: Adult; Aged; Clinical Article - Vascular; Female; Humans; Interventional Radiology; Intracranial Aneurysm - surgery; Male; Medicine; Medicine & Public Health; Middle Aged; Minimally Invasive Surgery; Neurology; Neuroradiology; Neurosurgery; Neurosurgical Procedures - adverse effects; Neurosurgical Procedures - instrumentation; Neurosurgical Procedures - methods; Retrospective Studies; Surgical Instruments - adverse effects; Surgical Orthopedics
• ISSN: 0001-6268; 0942-0940
• DOI: 10.1007/s00701-015-2448-y

Background Giant intracranial aneurysms (GIA) are often not eligible for direct clip occlusion. Surgical alternatives include partial clip occlusion or the placement of a cerebrovascular bypass or the combination of both. These alternative indirect strategies are expected to lead to a decrease in GIA volume over time rather than instantaneously. To examine whether this is the case, we analyzed follow-up imaging results 1 year after surgery. Methods We retrospectively screened the prospective GIA Registry’s imaging database for anterior circulation GIA treated by surgical strategies other than direct clipping. We measured pre- and 1-year post-treatment GIA volume, lateral ventricle volume (LVV), and mid-line shift (MLS) in 19 cases. Results After a mean follow-up of 466 days (standard deviation ±171) GIA volumes decreased from 9.6 cm 3 (interquartile range (IQR) 6.1–14.1) to 4.3 cm 3 (IQR 2.9–5.7; p