Late angiographic follow-up review of surgically treated aneurysms

Carlos A. David, A. Giancarlo Vishteh, Robert F. Spetzler, Gerald M Lemole, Michael T. Lawton, Shahram Partovi

Research output: Contribution to journalArticle

332 Citations (Scopus)

Abstract

Object. This study was undertaken to evaluate the long-term angiographic outcome of surgically treated aneurysms, which is unknown. Specifically, the incidence of recurrent aneurysms, the fate of residual necks, and the de novo formation of aneurysms were evaluated. Methods. One hundred two patients (80 females and 22 males; mean age 49 years; range 12-78 years) harboring a total of 167 aneurysms underwent late follow-up angiography; 160 aneurysms were surgically treated. Late angiographic follow-up review was obtained at a mean of 4.4 ± 1.6 years postsurgery (range 2.6-9.7 years). Late follow-up angiography revealed two recurrent aneurysms (1.5%) of 135 clipped aneurysms without residua. Of 12 aneurysms with known residua, there were eight 'dog- ear' residua, of which two (25%) enlarged. One hemorrhage was noted, yielding a hemorrhage risk of 1.9% per year. A second subgroup with broad-based residua revealed dramatic regrowth in three of four cases. Eight de novo aneurysms were found in six patients, for an annual risk of 1.8% per year. A history of multiple aneurysms was associated with de novo aneurysm formation (p = 0.049, chi-square analysis). Conclusions. This study confirms the long- term efficacy of aneurysm clip ligation. In addition, the authors found there is a small but significant risk of de novo aneurysm formation, particularly in patients with multiple aneurysms. Most residual aneurysm rests appear to remain stable, although a subset may enlarge or rupture. These findings support the rationale for late angiographic follow-up review in patients with aneurysms.

Original languageEnglish (US)
Pages (from-to)396-401
Number of pages6
JournalJournal of Neurosurgery
Volume91
Issue number3
StatePublished - Sep 1999

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Aneurysm
Angiography
Hemorrhage
Surgical Instruments
Ligation
Ear
Rupture
Neck

Keywords

  • Aneurysm
  • Aneurysm residuum
  • De novo aneurysm
  • Late follow-up angiography
  • Postoperative angiography

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

David, C. A., Vishteh, A. G., Spetzler, R. F., Lemole, G. M., Lawton, M. T., & Partovi, S. (1999). Late angiographic follow-up review of surgically treated aneurysms. Journal of Neurosurgery, 91(3), 396-401.

Late angiographic follow-up review of surgically treated aneurysms. / David, Carlos A.; Vishteh, A. Giancarlo; Spetzler, Robert F.; Lemole, Gerald M; Lawton, Michael T.; Partovi, Shahram.

In: Journal of Neurosurgery, Vol. 91, No. 3, 09.1999, p. 396-401.

Research output: Contribution to journalArticle

David, CA, Vishteh, AG, Spetzler, RF, Lemole, GM, Lawton, MT & Partovi, S 1999, 'Late angiographic follow-up review of surgically treated aneurysms', Journal of Neurosurgery, vol. 91, no. 3, pp. 396-401.
David CA, Vishteh AG, Spetzler RF, Lemole GM, Lawton MT, Partovi S. Late angiographic follow-up review of surgically treated aneurysms. Journal of Neurosurgery. 1999 Sep;91(3):396-401.
David, Carlos A. ; Vishteh, A. Giancarlo ; Spetzler, Robert F. ; Lemole, Gerald M ; Lawton, Michael T. ; Partovi, Shahram. / Late angiographic follow-up review of surgically treated aneurysms. In: Journal of Neurosurgery. 1999 ; Vol. 91, No. 3. pp. 396-401.
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abstract = "Object. This study was undertaken to evaluate the long-term angiographic outcome of surgically treated aneurysms, which is unknown. Specifically, the incidence of recurrent aneurysms, the fate of residual necks, and the de novo formation of aneurysms were evaluated. Methods. One hundred two patients (80 females and 22 males; mean age 49 years; range 12-78 years) harboring a total of 167 aneurysms underwent late follow-up angiography; 160 aneurysms were surgically treated. Late angiographic follow-up review was obtained at a mean of 4.4 ± 1.6 years postsurgery (range 2.6-9.7 years). Late follow-up angiography revealed two recurrent aneurysms (1.5{\%}) of 135 clipped aneurysms without residua. Of 12 aneurysms with known residua, there were eight 'dog- ear' residua, of which two (25{\%}) enlarged. One hemorrhage was noted, yielding a hemorrhage risk of 1.9{\%} per year. A second subgroup with broad-based residua revealed dramatic regrowth in three of four cases. Eight de novo aneurysms were found in six patients, for an annual risk of 1.8{\%} per year. A history of multiple aneurysms was associated with de novo aneurysm formation (p = 0.049, chi-square analysis). Conclusions. This study confirms the long- term efficacy of aneurysm clip ligation. In addition, the authors found there is a small but significant risk of de novo aneurysm formation, particularly in patients with multiple aneurysms. Most residual aneurysm rests appear to remain stable, although a subset may enlarge or rupture. These findings support the rationale for late angiographic follow-up review in patients with aneurysms.",
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