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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
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Patient Outcomes and Cerebral Infarction after Ruptured Anterior Communicating Artery Aneurysm Treatment
J J Heit1, R L Ball2, N A Telischak3
1From the Department of Radiology, Neuroimaging and Neurointervention Division (J.J.H., N.A.T., H.M.D., M.W., M.P.M.) jheit@stanford.edu.
AJNR. American Journal of Neuroradiology
|September 9, 2017
Summary
Surgical clipping of anterior communicating artery aneurysms leads to more frontal lobe and artery of Heubner infarctions, resulting in worse outcomes at discharge compared to coiling.
Area of Science:
- Neurosurgery
- Neurology
- Radiology
Background:
- Anterior communicating artery (ACoA) aneurysm rupture is linked to significant patient dependency.
- Clipping treatment is associated with worse outcomes than coiling.
- Ischemic injury may explain outcome differences between treatment modalities.
Purpose of the Study:
- To investigate cerebral infarction burden and patterns after ACoA aneurysm treatment.
- To compare patient outcomes following surgical clipping versus endovascular coiling.
Main Methods:
- Retrospective cohort study of ruptured ACoA aneurysm patients.
- Analysis of neuroimaging and clinical data.
- Propensity score matching to control for treatment assignment bias.
Main Results:
- Clipped patients experienced more ischemic frontal lobe and recurrent artery of Heubner infarctions.
- Clipped patients had higher rates of functional dependency at discharge.
- No significant differences in mortality or 3-month outcomes between groups.
Conclusions:
- Frontal lobe and recurrent artery of Heubner infarctions are more frequent after surgical clipping.
- These infarctions correlate with poorer clinical outcomes at discharge following ACoA aneurysm treatment.
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