Microsurgical clipping of previously ruptured, coiled aneurysms

 

A total of 53 patients from Phoenix and San Francisco, who initially presented with a subarachnoid hemorrhage and underwent surgical clipping of a previously coiled intracranial aneurysm between December 1997 and December 2014 were studied. Clinical features, hospital course, and preoperative and most recent functional status (Glasgow Outcome Scale score) were reviewed retrospectively.

The mean time interval from coiling to clipping was 2.6 years, and mean follow-up was 5.5 years (range, 0.1-14.7 years). Five patients (9.8%) presented with rebleed prior to clipping. Most patients (79.3%, 42/53) experienced good neurologic outcomes. Most showed no change (81%, 43/53) or improvement (13%, 7/53) in functional status after microsurgical clipping. One patient (2%) deteriorated clinically, and there were 2 mortalities (4%).

Microsurgical clipping of previously ruptured, coiled aneurysms is a promising treatment method with favorable clinical outcomes 1).1) Nisson PL, Meybodi AT, Roussas A, James W, Berger GK, Benet A, Lawton MT. Surgical Clipping of Previously Ruptured, Coiled Aneurysms: Outcome Assessment in 53 Patients. World Neurosurg. 2018 Dec;120:e203-e211. doi: 10.1016/j.wneu.2018.07.293. Epub 2018 Aug 23. PubMed PMID: 30144619.

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