Predictive Factors of Cerebral Aneurysm Rerupture After Clipping

Area of Science:

• Neurosurgery
• Cerebrovascular Disease
• Medical Imaging

Background:

• Aneurysmal clipping surgery is a common treatment for cerebral aneurysms.
• Estimating rerupture risk and understanding long-term outcomes are crucial after initial treatment.
• The modified Rankin Scale (mRS) is proposed as a functional outcome measure comparable to the Hunter and Hess scale.

Purpose of the Study:

• To determine the risk of aneurysm rerupture following first-time aneurysmal clipping.
• To identify factors associated with aneurysm rerupture.
• To evaluate long-term physical functionality using the mRS scale.

Main Methods:

• Retrospective analysis of 171 patients treated with aneurysmal clipping for ruptured cerebral aneurysms.
• Data collection included demographics, medical records, neuroimaging, Hunter and Hess scale, and mRS scores.
• Follow-up duration averaged 4.28 years.

Main Results:

• 48.5% of patients experienced aneurysm rerupture post-clipping.
• Higher Hunter and Hess and mRS scores were observed in the reruptured group.
• Risk factors for rerupture included postoperative mRS >2, smoking, multiple aneurysms, and specific locations (ACA, Pcom).

Conclusions:

• Aneurysm rerupture is a significant concern, affecting nearly half of patients in this cohort.
• Smoking, multiple aneurysms, and ACA/Pcom locations are key risk factors for rerupture.
• The mRS scale demonstrates comparable predictive power to the Hunter and Hess scale for long-term functional assessment.