ArticleActa neurochirurgica2021
Frequency and risk factors for postoperative aneurysm residual after microsurgical clipping.
Article in Acta neurochirurgica, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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9 citing papers in PubMed, 16 citations in OpenAlex.
- [Association between early stenosis and temporary clipping in treated cerebral aneurysms].Revista medica del Instituto Mexicano del Seguro Social · 2026Article
- Pitfalls in Intracranial Aneurysm Clipping: How to Avoid and How to Get out of Them.Journal of clinical medicine · 2025Article
- Article
- Navigating Complexity: A Comprehensive Approach to Middle Cerebral Artery Aneurysms.Journal of clinical medicine · 2024Article
- European survey on follow-up strategies for unruptured intracranial aneurysms.Brain & spine · 2024Article
- Exploring the hemodynamic behavior of residual aneurysms after coiling and clipping: A computational flow dynamic analysis.Surgical neurology international · 2024Article
- Cerebral Aneurysm and Interleukin-6: a Key Player in Aneurysm Generation and Rupture or Just One of the Multiple Factors?Translational stroke research · 2023Review
- Single-Energy Metal Artifact Reduction (SEMAR) in Ultra-High-Resolution CT Angiography of Patients with Intracranial Implants.Diagnostics (Basel, Switzerland) · 2023Article
- Partial Clipping Occlusion Including Rupture Point Is an Effective Strategy for Ruptured Giant Fusiform Basilar Artery Aneurysm: A Technical Case Report.Frontiers in neurology · 2021Article
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveAneurysm residuals after clipping are a well-known problem, but the course of aneurysm remnants in follow-up is not well studied. No standards or follow-up guidelines exist for treatment of aneurysm remnants. The aim of this study was to evaluate the risk factors for postoperative aneurysm remnants and their changes during follow-up.
methodsWe performed a retrospective analysis of 666 aneurysms treated via clipping in our hospital from 2006 to 2016. Postoperative and follow-up angiographic data were analyzed for aneurysm remnants and regrowth. Clinical parameters and aneurysm-specific characteristics were correlated with radiological results.
resultsThe frequency of aneurysm residuals was 12% (78/666). Aneurysms located in the middle cerebral artery (p = 0.02) showed a significantly lower risk for incomplete aneurysm occlusion. Larger aneurysms with a diameter of 11-25 mm (p = 0.005) showed a significantly higher risk for incomplete aneurysm occlusion. Five patients underwent re-clipping during the same hospital stay. Remnants were stratified based on morphological characteristics into "dog ears" (n = 60) and "broad based" (n = 13). The majority of the "dog ears" stayed stable, decreased in size, or vanished during follow-up. Broad-based remnants showed a higher risk of regrowth.
conclusionsA middle cerebral artery location seems to lower the risk for the incomplete clip occlusion of an aneurysm. Greater aneurysm size (11-25 mm) is associated with a postoperative aneurysm remnant. The majority of "dog-ear" remnants appear to remain stable during follow-up. In these cases, unnecessarily frequent angiographic checks could be avoided. By contrast, broad-based residuals show a higher risk of regrowth that requires close imaging controls if retreatment cannot be performed immediately.
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