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Updated: Jun 5, 2026
Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
Published on: August 11, 2015
[The analysis of intracranial aneurysms undergoing surgical treatment]
Chen Wu1, Bai-nan Xu, Bao-min Li
1Neurosurgery Department, General Hospital of People's Liberation Army, Beijing 100853, China.
Insights
Surgical clipping and endovascular coiling are effective treatments for intracranial aneurysms. Individualized treatment selection ensures safe, effective, and durable outcomes for patients.
Area of Science:
- Neurosurgery
- Vascular Neurology
- Interventional Radiology
Context:
- Intracranial aneurysms pose significant risks, necessitating effective treatment strategies.
- Surgical and endovascular techniques are primary interventions for managing these vascular malformations.
Purpose:
- To evaluate the surgical principles and treatment outcomes of intracranial aneurysms.
- To compare the efficacy of open surgery versus endovascular coiling for aneurysm treatment.
Summary:
- A retrospective study of 139 patients (80 open surgery, 59 endovascular) with intracranial aneurysms was conducted.
- Open surgical methods included clipping, trapping, or wrapping; endovascular methods included coiling or stent-assisted coiling.
- Both surgical clipping and endovascular coiling demonstrated high rates of favorable outcomes (Glasgow Outcome Scale 4 or 5: 88.8% surgical, 91.5% endovascular).
Impact:
- Both surgical clipping and endovascular coiling are viable, safe, and effective treatment options for intracranial aneurysms.
- Individualized patient assessment is crucial for selecting the optimal treatment approach.
- This study underscores the importance of tailored treatment strategies for achieving durable patient outcomes.
Objective:
To study the surgical principles and treatment options of intracranial aneurysms.
Methods:
One hundred and thirty nine patients with intracranial aneurysms were retrospectively studied, including 80 open-surgery cases and 59 endovascular-treated cases from January to December in 2009. Open surgical methods included clipping, trapping or wrapping and interventional methods included simple coiling or stent-assisted coiling. Intra-operative electroencephalogram and somatosensory evoked potentials monitoring were regularly used. Microvascular doppler ultrasonography and indocyanine green videoangiography were used to assess blood flow in parent and branch vessels.
Results:
Seventy-three aneurysms were directly clipped, 6 were trapped and 1 was wrapped. Thirty-three aneurysms were coiled and 26 were coiled assisted with stents. At discharge, 71 of the 80(88.8%) surgical treated patients had Glasgow Outcome Scale score of 4 or 5 points, 3 points in 6 patients (7.5%), 2 points in 1 patient (1.2%), and 1 point in 2 patients (2.5%). Fifty-four out of 59 cases underwent endovascular treatment scored 4 or 5 points (91.5%) and 3 points in 5 patients (8.5%).
Conclusions:
Surgical clipping and endovascular coiling are two major treatment choices for intracranial aneurysms. The treatment option should be individualized based on the patients' specific conditions, which could have a safe, effective and durable outcome.
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