Outcome of microsurgical clipping of anterior communicating aneurysms: A single-centre experience

M. N. Kumar, R. Prasad, Senthil Kumar, A. Pravallika
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Abstract

Anterior communicating (ACOM) aneurysms are the most common intracranial aneurysms. About 30%–40% of ruptured intracranial aneurysms are ACOM aneurysms. Its complex structural and anatomical variability and its critical location pose a great challenge to the surgeon during microsurgical clipping. We share our experience in clipping these aneurysms and its outcome. The aim was to study the outcome following microsurgical clipping of ACOM artery aneurysm presenting with rupture and subarachnoid haemorrhage and to determine the factors which dictate the clinical outcome after 6 months. The study includes all cases of ruptured ACOM aneurysms who underwent microsurgical clipping between the period of 2016 and 2020. The medical records were analysed retrospectively and results were recorded. The study shows that the outcome of the patients depends on presenting World Federation of Neurological Surgeons grade, anterosuperiorly projecting aneurysms are at high risk for intraoperative rupture and complications such as lacunar infarcts are common with the usage of temporary clips.
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显微外科夹闭前交通动脉瘤的疗效:单中心经验
前交通动脉瘤是最常见的颅内动脉瘤。约30%-40%的破裂颅内动脉瘤为ACOM动脉瘤。其复杂的结构和解剖变异性以及关键的位置对外科医生在显微手术中进行夹夹提出了很大的挑战。我们分享我们的经验,夹这些动脉瘤和它的结果。目的是研究显微手术夹闭出现破裂和蛛网膜下腔出血的ACOM动脉瘤后的结果,并确定决定6个月后临床结果的因素。该研究包括2016年至2020年期间接受显微手术切除的所有ACOM动脉瘤破裂病例。回顾性分析病历并记录结果。研究表明,患者的预后取决于世界神经外科医师联合会的分级,上向前突出的动脉瘤术中破裂的风险很高,使用临时夹夹时腔隙性梗死等并发症很常见。
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