Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Analysis of Clip-induced Ischemic Complication of Anterior Choroidal Artery Aneurysms

  • Cho, Min-Soo (Department of Neurosurgery College of Medicine Yeungnam University) ;
  • Kim, Min-Su (Department of Neurosurgery College of Medicine Yeungnam University) ;
  • Chang, Chul-Hoon (Department of Neurosurgery College of Medicine Yeungnam University) ;
  • Kim, Sang-Woo (Department of Neurosurgery College of Medicine Yeungnam University) ;
  • Kim, Seong-Ho (Department of Neurosurgery College of Medicine Yeungnam University) ;
  • Choi, Byung-Yon (Department of Neurosurgery College of Medicine Yeungnam University)
  • Published : 2008.03.18
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Abstract

Objective: The surgical approach for anterior choroidal artery (AChA) aneurysm is typically similar to those used for other supraclinoid internal carotid artery (ICA) lesions. However, the surgical clipping of this aneurysm is complicated and as a result. can result in postoperative ischemic complications. The purpose of this study was to clarify the risk of clip-induced ischemic complication in AChA aneurysm and to get the benefits for helping decision making. Methods: We retrospectively investigated 53 cases (4.0%) of AchA aneurysm treated surgically. We divided the AChA aneurysm to 3 subtype according to the origin of aneurysmal neck; A type originating from the AChA itself. J type from junction of AChA and ICA and I type from the ICA itself. We evaluated brain CT about 1 week post-operative day to confirm the low density in AChA territory. Results: Ruptured aneurysm was 26 cases and unruptured aneurysm 27 cases. The aneurysmal subtype of A, J, and I was 13, 17, and 23 cases. Of the 53 cases who performed surgical neck clipping, twelve (22.6%) had postoperative AChA distribution infarcts. Increased infarct after neck clipping had statistic significance in non-I subtype (r=0.005) Conclusion: AChA aneurysm surgery carries a significant risk of postoperative stroke. Don't always stick to clipping only, especially in non-I type of incidental small aneurysm, which has high risk of post-clip ischemic complications.

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References

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