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Updated: Dec 29, 2025
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Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment
Published on: September 25, 2009
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A new definition for wide-necked cerebral aneurysms.
Hyun Seok Park1, Soon Chan Kwon2, Eun Suk Park2
1Department of Neurosurgery, Dong Kang Medical Center, Ulsan, Korea.
Journal of Cerebrovascular and Endovascular Neurosurgery
|February 8, 2020
Summary
The K-ratio is the most effective measure for identifying wide-necked aneurysms that require adjunctive devices during endovascular treatment. This finding helps define wide-necked aneurysms needing complex management.
Area of Science:
- Neurosurgery
- Interventional Radiology
- Vascular Surgery
Background:
- Endovascular treatment of wide-necked aneurysms often necessitates adjunctive devices.
- Existing definitions for wide-necked aneurysms (dome-to-neck ratio, aspect ratio) lack consistency.
- A clear definition is needed to predict the requirement for adjunctive devices.
Purpose of the Study:
- To identify the most reliable definition for wide-necked aneurysms.
- To determine which ratio best predicts the need for adjunctive devices in endovascular aneurysm repair.
Main Methods:
- Analysis of 552 aneurysm cases (343 unruptured, 209 ruptured).
- Measurement of dome-to-neck ratio, aspect ratio, and K-ratio for each aneurysm.
- Statistical analysis to compare the predictive power of each ratio for adjunctive device use.
Main Results:
- 50.2% of aneurysms required adjunctive techniques.
- The K-ratio demonstrated the strongest predictive value for adjunctive device use (P<0.001).
- A K-ratio cutoff of 1.3 provided optimal sensitivity (72.9%) and specificity (63.6%).
Conclusions:
- The K-ratio is the most effective parameter for defining wide-necked aneurysms requiring adjunctive devices.
- This ratio can aid in standardizing the definition and management of complex aneurysms.
- The K-ratio offers a valuable tool for predicting procedural complexity in endovascular aneurysm treatment.
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