ArticleNeurosurgical review2021
Clinical features of ischemic complications after unruptured middle cerebral artery aneurysm clipping: patients and radiologically related factors.
Article in Neurosurgical review, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 10 citations in OpenAlex.
- Outcomes of Microsurgical Treatment for Unruptured Intracranial Aneurysms: A 7-Year Institutional Review.Neurosurgery practice · 2026Article
- Propensity Score-Matched Analysis of Endovascular Treatment and Microsurgery for Unruptured Middle Cerebral Artery Aneurysms: Long-Term Outcomes over 6-Year Follow-Up.Journal of clinical medicine · 2026Article
- Comparison of feasibility and efficacy of microsurgery and interventional techniques in the management of unruptured middle cerebral artery aneurysms with a history of transient ischemic attack.Frontiers in surgery · 2026Article
- Risk factors and the role of intraoperative hypotension in cerebral infarction after microsurgical clipping of intracranial aneurysms: a retrospective case-control study.Neurosurgical review · 2025Article
- Risk of postoperative major adverse cerebrovascular events in patients with spontaneous intracranial hematoma stratified by type 2 diabetes mellitus.Frontiers in human neuroscience · 2025Article
- A novel predictor of ischemic complications in the treatment of ruptured middle cerebral artery aneurysms: Neck-branching angle.World neurosurgery: X · 2024Article
- The impact of high-resolution cone-beam CT findings on decision-making for the treatment of unruptured middle cerebral artery aneurysms.Neurosurgical review · 2022Article
- The development of a new, ultra-fine, and flexible neuroendoscope for intracranial observation.Surgical neurology international · 2022Article
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Postoperative ischemic complication results in neurological sequelae and longer hospitalization after unruptured middle cerebral artery (MCA) aneurysm clipping surgery. We evaluated the radiological and patient-related factors associated with ischemic complications after unruptured MCA aneurysm clipping surgery. Patient demographics, radiological findings, and intraoperative factors were compared between patients with and without postoperative ischemic complications. The clinical courses and outcomes of postoperative ischemic complications were compared according to the types of ischemic complication. Forty-two out of 2227 patients (1.9%) developed postoperative ischemic complications after MCA aneurysm clipping. Multivariate analysis revealed that diabetes mellitus (DM) was a patient-related factor. Intraarterial (IA) calcification of the distal internal carotid artery (ICA), preoperative M1 stenosis, and M1 aneurysm were radiological factors that increased the risk of postoperative ischemic complications. DM was significantly associated with divisional branch territory infarction (P = 0.04). The time to first presentation of ischemic complication was significantly longer in divisional branch territory infarction than perforator territory infarction (67.8 ± 75.9 h vs. 22 ± 20.7, P = 0.023). Twelve out of 42 patients with ischemic complications (28.6%) had unfavorable outcome (mRS > 3). Perforator territory infarction was significantly associated with an unfavorable outcome (mRS > 3, P = 0.019). IA calcification of the distal ICA, M1 stenosis and aneurysms, and DM were significantly associated with postoperative ischemic complications after unruptured MCA aneurysm clipping. Patients with DM should be closely monitored postoperatively to detect delayed occurrence of divisional branch infarction. Trial registration number: 2019-1002, Date of registration: January 1, 2005, "retrospectively registered".
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