caa a22 4500 606215956 CHVBK 20210128101101.0 cr unu---uuuuu 210128e20150801xx s 000 0 eng 10.1007/s00701-015-2460-2 doi (NATIONALLICENCE)springer-10.1007/s00701-015-2460-2 Treatment outcomes of unruptured intracranial aneurysm; experience of 1231 consecutive aneurysms [Elektronische Daten] [Jihye Song, Bum-Soo Kim, Yong Shin] Background: The aim of this study was to review our experience with surgical clipping and endovascular treatment (EVT) of unruptured intracranial aneurysms (UIAs), with a special focus on complications. Methods: We retrospectively analyzed clinical and radiological data from patients who underwent surgery or EVT. Surgery was performed by one neurosurgeon, and EVT was performed by two neurointerventionists according to one hybrid neurosurgeon's decision. Adverse events included the following: (1) decline of the modified Rankin Scale (mRS) score from 1 to 2 and (2) any unexpected neurological deficit or imaging finding affecting the prognosis and/or requiring additional procedures, medication, or prolonged hospital stay. Results: Of the 1231 UIAs in 1124 patients, 625 (50.7%) aneurysms were treated with surgery, and 606 (49.3%) aneurysms were treated with EVT. The overall complication rate of UIA treatment was 3.2%. The rate of adverse events was 2.4%, and the rates of morbidity and mortality were 0.6 and 0.2%, respectively. The rates of adverse events, morbidity, and mortality were not significantly different between surgery and EVT. The rate of hospital use for EVT was stationary over the years of the study. Posterior circulation in surgery, large aneurysms (>15mm) in EVT, and stent- or balloon-assisted procedures in EVT were associated with the occurrence of complications. Poor clinical outcome (mRS of 3-6) was 0.8% at hospital discharge. Conclusions: Both UIA treatment modalities decided by one hybrid neurosurgeon showed low complication rates and good clinical outcomes in this study. These results may serve as a point of reference for clinical decision-making for patients with UIA. Springer-Verlag Wien, 2015 Intracranial aneurysm nationallicence Endovascular procedure nationallicence Surgical clipping nationallicence Morbidity nationallicence Mortality nationallicence Adverse events nationallicence UIA : unruptured intracranial aneurysm nationallicence EVT : endovascular treatment nationallicence SAH : subarachnoid hemorrhage nationallicence mRS : modified Rankin Scale nationallicence CT : computed tomography nationallicence MR : magnetic resonance nationallicence MRI : magnetic resonance imaging nationallicence ISUIA : International Study of Unruptured Intracranial Aneurysms nationallicence MMSE : Mini-Mental State Examination nationallicence SD : standard deviation nationallicence OR : odds ratio nationallicence CI : confidence interval nationallicence Song Jihye Department of Neurosurgery, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Banpo-daero 222, 137-701, Seocho-gu, Seoul, South Korea aut Kim Bum-Soo Department of Radiology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea aut Shin Yong Department of Neurosurgery, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Banpo-daero 222, 137-701, Seocho-gu, Seoul, South Korea aut Acta Neurochirurgica Springer Vienna 157/8(2015-08-01), 1303-1311 0001-6268 157:8<1303 2015 157 701 https://doi.org/10.1007/s00701-015-2460-2 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/s00701-015-2460-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Song Jihye Department of Neurosurgery, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Banpo-daero 222, 137-701, Seocho-gu, Seoul, South Korea aut NATIONALLICENCE 700 1- Kim Bum-Soo Department of Radiology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Shin Yong Department of Neurosurgery, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Banpo-daero 222, 137-701, Seocho-gu, Seoul, South Korea aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer Vienna 157/8(2015-08-01), 1303-1311 0001-6268 157:8<1303 2015 157 701