Results of surgical clipping in a neurointerventional dominant department

British Journal of Neurosurgery
Mario TeoJerome St George

Abstract

It has been 10 years since the publication of International Subarachnoid Aneurysm Trial (ISAT) (1-3) and the first-line treatment for cerebral aneurysms in many UK neurosurgical centres is endovascular occlusion. Local audit has shown a significant reduction in surgical clipping cases since 2002, with a fall from over 150 cases per year pre ISAT, to approximately 25 cases per year currently. More so the cases referred for surgical occlusion represent more challenging lesions. With such a reduction in surgical numbers we felt it prudent to review our recent surgical outcomes. Retrospective analysis of prospectively collected data. 47 patients (32 females, 15 males), mean age: 53 (range, 29-74) years underwent surgical clipping of cerebral aneurysms from January 2012 to September 2013. Case notes, neuroradiology reports and cerebral angiograms were reviewed. Patient outcome was stratified according to Glasgow Outcome Score; 4-5 good outcome and 1-3 poor outcome. Of the aneurysms clipped, 40 patients had suffered a subarachnoid haemorrhage and 7 were treated for unruptured aneurysms. The reasons for referral for surgical clipping were the presence of an aneurysmal clot 9 (19%), 'failed coiling' 16 (34%) and unsuitability for endov...Continue Reading

References

Feb 11, 1992·Stroke; a Journal of Cerebral Circulation·E C HaleyJ C Torner
Oct 2, 2007·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Andrew MolyneuxRury Holman
Feb 12, 2013·Acta neurochirurgica·Maria WostrackBernhard Meyer
Jul 9, 2013·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Niklas SandströmPeter Mitchell

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Citations

Jan 7, 2016·World Neurosurgery·Ramazan JabbarliUlrich Sure
Sep 19, 2018·Acta neurochirurgica·Lukas GoertzBoris Krischek

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