Evidence map›Paper›PMID 40272584›Full record

ArticleNeurosurgical review2025

The optimal temporary occlusion time for the treatment of internal carotid artery aneurysms.

Nakao Ota, Yasuhiro Hagiwara, Fozia Saeed, Takuma Takano, Yasuaki Okada, Kohei Yoshikawa, Kosumo Noda, Rokuya Tanikawa

Abstract read
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In one paragraph

Article in Neurosurgical review, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Nakao OtaDepartment of Neurosurgery, Sapporo Teishinkai Hospital, 3 - 1, Higashi 1, Kita 33, Higashi-Ku, Sapporo, Hokkaido, 065 - 0033, Japan. nakao1980@gmail.com.ORCID http://orcid.org/0000-0002-7074-1125
Yasuhiro HagiwaraDepartment of Biostatistics, School of Public Health, The University of Tokyo, Tokyo, Japan.
Fozia SaeedDepartment of Neurosurgery, Sapporo Teishinkai Hospital, 3 - 1, Higashi 1, Kita 33, Higashi-Ku, Sapporo, Hokkaido, 065 - 0033, Japan.
Takuma TakanoDepartment of Neurosurgery, Sapporo Teishinkai Hospital, 3 - 1, Higashi 1, Kita 33, Higashi-Ku, Sapporo, Hokkaido, 065 - 0033, Japan.
Yasuaki OkadaDepartment of Neurosurgery, Sapporo Teishinkai Hospital, 3 - 1, Higashi 1, Kita 33, Higashi-Ku, Sapporo, Hokkaido, 065 - 0033, Japan.
Kohei YoshikawaDepartment of Neurosurgery, Sapporo Teishinkai Hospital, 3 - 1, Higashi 1, Kita 33, Higashi-Ku, Sapporo, Hokkaido, 065 - 0033, Japan.
Kosumo NodaDepartment of Neurosurgery, Sapporo Teishinkai Hospital, 3 - 1, Higashi 1, Kita 33, Higashi-Ku, Sapporo, Hokkaido, 065 - 0033, Japan.
Rokuya TanikawaDepartment of Neurosurgery, Sapporo Teishinkai Hospital, 3 - 1, Higashi 1, Kita 33, Higashi-Ku, Sapporo, Hokkaido, 065 - 0033, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Post-operative silent DWI hyperintensities are potential risk factors for cognitive dysfunction. Microsurgical clipping offers high occlusion rates and low recurrence, and temporary occlusion is often essential to safely dissect aneurysms. However, addressing these DWI changes is crucial for improving outcomes and minimizing complications. This study aimed to determine the optimal temporary occlusion time for ICA aneurysm treatment. A retrospective analysis was performed on 267 cases of ICA aneurysms. Clinical outcomes and factors associated with post-operative DWI hyperintensities were analyzed. The post-operative DWI hyperintensities were classified as either perforating artery infarction or 'other' infarction. Of 267 cases, post-operative DWI hyperintensity signals were observed in 38 cases (14.2%), including two symptomatic cases. Temporary occlusion was performed in 239 cases (89.5%), and retrograde suction and decompression (RSD) in 65 cases (24.3%). Multi-variate analysis revealed a significant association between maximum temporary occlusion duration (per 1-min increment) and perforator infarction (OR: 1.29, 95% CI [1.07-1.54]). Temporary occlusion under 5 min presented the lowest risk of DWI changes, while risks significantly increased beyond 12.5 min. Poor outcomes (mRS ≥ 2) were noted in 6 patients (2.2%). Adjunct techniques such as temporary occlusion or RSD used in microsurgical clipping, allow for safer manipulation of ICA aneurysms and dissection of surrounding structures, enabling complete aneurysmal neck clipping. However, post-operative DWI hyperintensities particularly in the perforator infarction may be observed in cases with prolonged temporary occlusion. This study highlights the safety of temporary occlusion when performed for less than 5 min intervals for the treatment of ICA aneurysms.

Indexed as

Carotid Artery DiseasesCarotid Artery, InternalIntracranial AneurysmNeurosurgical ProceduresAdultAgedDiffusion Magnetic Resonance ImagingFemaleHumansMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesTime FactorsTreatment OutcomeCerebral infarctionClippingDiffusion weighted imagingInternal carotid artery aneurysmRetrograde suction and decompressionTemporary occlusion time

Identifiers

PMID40272584

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.