open access

Vol 47, No 1 (2013)
ARTYKUŁ ORYGINALNY
Submitted: 2018-10-24
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Assessment of long-term results of intracranial aneurysm clipping by means of computed tomography angiography

Przemysław Kunert, Marek Prokopienko, Magdalena Gola, Tomasz Dziedzic, Maciej Jaworski, Andrzej Marchel
DOI: 10.5114/ninp.2012.31549
·
Neurol Neurochir Pol 2013;47(1):18-26.

open access

Vol 47, No 1 (2013)
ARTYKUŁ ORYGINALNY
Submitted: 2018-10-24

Abstract

Background and purpose

The aim of this retrospective study was to assess the effectiveness of aneurysm clipping by computed tomography angiography (CTA) in a long-term follow-up.

Material and methods

The CTA examination was performed in 119 patients who had 143 aneurysms clipped. The examinations were performed 3 to 11 years (mean 6 years) after clipping using a GE Lightspeed PRO16 scanner.

Results

In all cases but one, good quality CTA images, suitable for evaluation of the arteries around the clip site, were obtained. Complete aneurysm closure without neck remnant or regrowth was confirmed in 137 (96%) aneurysms. In 4 (3%) cases, neck remnants were detected (2 on the anterior communicating artery [AComA] and 2 on the middle cerebral artery [MCA]). A total clip slippage from the aneurysm dome was revealed in 1 case. One case of aneurysm re-rupture was noted, 11 years after clipping. The rebleeding was caused by AComA aneurysm regrowth. Among these 6 patients with unsatisfactory clipping, 2 required further treatment and 4 remain under observation. Nineteen ‘de novo’ aneurysms in other locations were found in 14 (12%) patients. Summing up all of the pathological findings in the study group, there were 18 (15%) patients who needed further management including close surveillance or re-treatment.

Conclusions

Computed tomography angiography is a simple and reliable method of aneurysm clipping evaluation. The long-term follow-up CTA confirmed the permanent and complete obliteration of 96% of the aneurysms. The rate of unsatisfactory aneurysm closure was 4%, but only 1.4% needed re-treatment during a mean follow-up of 6 years. The annual risk of aneurysm re-rupture was 0.1%.

Abstract

Background and purpose

The aim of this retrospective study was to assess the effectiveness of aneurysm clipping by computed tomography angiography (CTA) in a long-term follow-up.

Material and methods

The CTA examination was performed in 119 patients who had 143 aneurysms clipped. The examinations were performed 3 to 11 years (mean 6 years) after clipping using a GE Lightspeed PRO16 scanner.

Results

In all cases but one, good quality CTA images, suitable for evaluation of the arteries around the clip site, were obtained. Complete aneurysm closure without neck remnant or regrowth was confirmed in 137 (96%) aneurysms. In 4 (3%) cases, neck remnants were detected (2 on the anterior communicating artery [AComA] and 2 on the middle cerebral artery [MCA]). A total clip slippage from the aneurysm dome was revealed in 1 case. One case of aneurysm re-rupture was noted, 11 years after clipping. The rebleeding was caused by AComA aneurysm regrowth. Among these 6 patients with unsatisfactory clipping, 2 required further treatment and 4 remain under observation. Nineteen ‘de novo’ aneurysms in other locations were found in 14 (12%) patients. Summing up all of the pathological findings in the study group, there were 18 (15%) patients who needed further management including close surveillance or re-treatment.

Conclusions

Computed tomography angiography is a simple and reliable method of aneurysm clipping evaluation. The long-term follow-up CTA confirmed the permanent and complete obliteration of 96% of the aneurysms. The rate of unsatisfactory aneurysm closure was 4%, but only 1.4% needed re-treatment during a mean follow-up of 6 years. The annual risk of aneurysm re-rupture was 0.1%.

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Keywords

intracranial aneurysm, aneurysm clipping, computed tomography angiography

About this article
Title

Assessment of long-term results of intracranial aneurysm clipping by means of computed tomography angiography

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 47, No 1 (2013)

Pages

18-26

DOI

10.5114/ninp.2012.31549

Bibliographic record

Neurol Neurochir Pol 2013;47(1):18-26.

Keywords

intracranial aneurysm
aneurysm clipping
computed tomography angiography

Authors

Przemysław Kunert
Marek Prokopienko
Magdalena Gola
Tomasz Dziedzic
Maciej Jaworski
Andrzej Marchel

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