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Clinical Outcome of Paraclinoid Internal Carotid Artery Aneurysms After Microsurgical Neck Clipping in Comparison with Endovascular Embolization

Title
Clinical Outcome of Paraclinoid Internal Carotid Artery Aneurysms After Microsurgical Neck Clipping in Comparison with Endovascular Embolization
Author
최규선
Keywords
Paraclinoid aneurysms; Microsurgical clipping; Endovascular coiling; Outcome
Issue Date
2014-09
Publisher
대한뇌혈관외과학회
Citation
Korean Society of Cerebrovascular Surgeons; Society of Korean Endovascular Neurosurgeons, 2014, 16(3), 225p ~ 234
Abstract
ObjectiveBecause of the complex anatomical association among vascular, dural, and bony structures, paraclinoid internal carotid artery (ICA) aneurysms remain a major challenge for vascular neurosurgeons. We studied the clinical outcomes of 61 paraclinoid ICA aneurysms after microsurgical clipping in comparison with endovascular coiling.Materials and MethodsBetween January 2008 and December 2012, we treated 61 paraclinoid ICA aneurysms created by surgical clipping or endovascular coiling. Preoperative neurologic status and postoperative outcome were evaluated using the Glasgow coma scale (GCS) and the modified Rankin scale (mRS). Postoperative hydrocephalus and vasospasm were reviewed using the patients' medical charts.ResultsMost patients were in good clinical condition before the operations and had good treatment outcomes. Clinical vasospasm was observed after the operation in five patients, and hydrocephalus occurred in six patients. No statistically significant difference regarding aneurysm size, sex, GCS score, H-H grade, and mRS was observed between the surgical clipping group and the endovascular coiling group. In addition, the treatment results and complications did not show statistically significant difference in either group.ConclusionSurgical occlusion of paraclinoid ICA aneurysms is difficult; however, no significant differences were observed in the treatment results or complications when compared with coil embolization. In particular, use of an adequate surgical technique may lead to better outcomes than those for coil embolization in the treatment of large and/or wide-neck paraclinoid ICA aneurysms.
URI
https://synapse.koreamed.org/DOIx.php?id=10.7461/jcen.2014.16.3.225http://hdl.handle.net/20.500.11754/48264
ISSN
2234-8565; 2287-3139
DOI
10.7461/jcen.2014.16.3.225
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COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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