caa a22 4500 606214399 CHVBK 20210128101052.0 cr unu---uuuuu 210128e20150701xx s 000 0 eng 10.1007/s00701-015-2448-y doi (NATIONALLICENCE)springer-10.1007/s00701-015-2448-y Changes in volume of giant intracranial aneurysms treated by surgical strategies other than direct clipping [Elektronische Daten] [Nicolai Maldaner, Susanne Guhl, Dorothee Mielke, Christian Musahl, Nils Schmidt, Maria Wostrack, Daniel Rüfenacht, Peter Vajkoczy, Julius Dengler] Background: Giant intracranial aneurysms (GIA) are often not eligible for direct clip occlusion. Surgical alternatives include partial clip occlusion or the placement of a cerebrovascular bypass or the combination of both. These alternative indirect strategies are expected to lead to a decrease in GIA volume over time rather than instantaneously. To examine whether this is the case, we analyzed follow-up imaging results 1year after surgery. Methods: We retrospectively screened the prospective GIA Registry's imaging database for anterior circulation GIA treated by surgical strategies other than direct clipping. We measured pre- and 1-year post-treatment GIA volume, lateral ventricle volume (LVV), and mid-line shift (MLS) in 19 cases. Results: After a mean follow-up of 466days (standard deviation ±171) GIA volumes decreased from 9.6cm3 (interquartile range (IQR) 6.1-14.1) to 4.3cm3 (IQR 2.9-5.7; p < 0.01). Ipsilateral LVV increased from 8.6cm3 (IQR 6.4-24.9) to 16.0cm3 (IQR 9.1-27.2; p < 0.01) while contralateral LVV increased from 10.3cm3 (IQR 7.3-20.1) to 11.7cm3 (IQR 8.2-19.4; p = 0.02). MLS changed from 0.1mm (IQR −1.9 to 2.0) to −0.9mm (IQR −1.8 to 0.4; p = 0.03). The decrease in GIA volume correlated with the increase in ipsilateral LVV (rs = 0.60; p = 0.01) but not with the changes in MLS (rs = 0.41; p = 0.08). Conclusions: In our patient cohort, surgical strategies other that direct clipping for the treatment of anterior circulation GIA lead to a significant decrease in GIA volume over time. The resulting decrease in mass effect was more sensitively monitored by the measurement of changes in ipsilateral LVV than changes in MLS. Clinical Trial Registration-URL: http://www.clinicaltrials.gov . Unique identifier: NCT02066493. Springer-Verlag Wien, 2015 Giant intracranial aneurysm nationallicence Cerebrovascular bypass nationallicence Brain mass effect nationallicence Lateral ventricle volume nationallicence Mid-line shift nationallicence Maldaner Nicolai Department of Neurosurgery, Charité - Universitätsmedizin Berlin, Berlin, Germany aut Guhl Susanne Department of Neurosurgery, University of Greifswald, Greifswald, Germany aut Mielke Dorothee Department of Neurosurgery, University of Goettingen, Goettingen, Germany aut Musahl Christian Department of Neurosurgery, Klinikum Stuttgart, Stuttgart, Germany aut Schmidt Nils Department of Neurosurgery, Universitätsklinikum Hamburg Eppendorf, Hamburg, Germany aut Wostrack Maria Department of Neurosurgery, Technical University of Munich, Munich, Germany aut Rüfenacht Daniel Department of Neuroradiology, Klinik Hirslanden, Zurich, Switzerland aut Vajkoczy Peter Department of Neurosurgery, Charité - Universitätsmedizin Berlin, Berlin, Germany aut Dengler Julius Department of Neurosurgery, Charité - Universitätsmedizin Berlin, Berlin, Germany aut Acta Neurochirurgica Springer Vienna 157/7(2015-07-01), 1117-1123 0001-6268 157:7<1117 2015 157 701 https://doi.org/10.1007/s00701-015-2448-y text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00701-015-2448-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Maldaner Nicolai Department of Neurosurgery, Charité - Universitätsmedizin Berlin, Berlin, Germany aut NATIONALLICENCE 700 1- Guhl Susanne Department of Neurosurgery, University of Greifswald, Greifswald, Germany aut NATIONALLICENCE 700 1- Mielke Dorothee Department of Neurosurgery, University of Goettingen, Goettingen, Germany aut NATIONALLICENCE 700 1- Musahl Christian Department of Neurosurgery, Klinikum Stuttgart, Stuttgart, Germany aut NATIONALLICENCE 700 1- Schmidt Nils Department of Neurosurgery, Universitätsklinikum Hamburg Eppendorf, Hamburg, Germany aut NATIONALLICENCE 700 1- Wostrack Maria Department of Neurosurgery, Technical University of Munich, Munich, Germany aut NATIONALLICENCE 700 1- Rüfenacht Daniel Department of Neuroradiology, Klinik Hirslanden, Zurich, Switzerland aut NATIONALLICENCE 700 1- Vajkoczy Peter Department of Neurosurgery, Charité - Universitätsmedizin Berlin, Berlin, Germany aut NATIONALLICENCE 700 1- Dengler Julius Department of Neurosurgery, Charité - Universitätsmedizin Berlin, Berlin, Germany aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer Vienna 157/7(2015-07-01), 1117-1123 0001-6268 157:7<1117 2015 157 701