Clipping Surgery for Unruptured Middle Cerebral Artery Aneurysms

Area of Science:

• Neurosurgery
• Vascular Neurology
• Surgical Outcomes

Background:

• Unruptured middle cerebral artery aneurysms pose a risk of rupture and neurological deficit.
• Surgical clipping remains a primary treatment modality for these aneurysms.
• Assessing the safety and efficacy of clipping for unruptured aneurysms is crucial for clinical decision-making.

Purpose of the Study:

• To evaluate the perioperative morbidity and mortality associated with clipping surgery for unruptured middle cerebral artery aneurysms.
• To identify factors contributing to complications during the surgical procedure.
• To emphasize the importance of advanced monitoring techniques for safe surgical outcomes.

Main Methods:

• Retrospective analysis of 139 consecutive clipping surgeries for unruptured middle cerebral artery aneurysms.
• Data collection on perioperative complications, including neurological deficits and transient symptoms.
• Utilization of intraoperative monitoring, including MEP (motor evoked potentials) and ICG (indocyanine green) videoangiography.

Main Results:

• A low incidence of permanent morbidity (0.7% left hemiparesis) was observed.
• Transient neurological symptoms occurred in six patients (4.3%) due to various causes like perforator injury or venous system damage.
• No mortality or decline in cognitive function was reported in the study cohort.

Conclusions:

• Clipping surgery for unruptured middle cerebral artery aneurysms can be performed with minimal morbidity and mortality.
• Meticulous perioperative management is essential for patient safety.
• The integration of modern technologies, such as MEP monitoring and ICG videoangiography, enhances surgical safety and security.