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Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms

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[Russian study on brain aneurysm surgery: a continuation (RIHA II)].

V V Krylov^1,2,3, T A Shatokhin^1,2,3, I M Shetova³

¹Pirogov Russian National Research Medical University, Moscow, Russia.

Zhurnal Voprosy Neirokhirurgii Imeni N. N. Burdenko

|February 9, 2024

Summary

Neurosurgical interventions for cerebral aneurysms decreased, with a shift towards endovascular techniques and improved outcomes. More surgeries occurred in the acute hemorrhage period, indicating enhanced neurosurgical service performance.

Keywords:

aneurysm clipping cerebral aneurysms endovascular treatment of cerebral aneurysms subarachnoid hemorrhage surgical treatment of aneurysms

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Area of Science:

Neurosurgery
Vascular Neurology
Public Health

Context:

Analysis of neurosurgical departments in the Russian Federation between 2017 and 2021.
Inclusion of 6,135 patients across 22 neurosurgical departments.
Assessment of cerebral aneurysm treatment trends and outcomes.

Purpose:

To evaluate key performance indicators in the surgical treatment of cerebral aneurysms.
To identify factors influencing postoperative outcomes in neurosurgical departments.
To track changes in treatment modalities and patient outcomes over time.

Summary:

A decrease in overall cerebral aneurysm surgeries was observed, potentially linked to the COVID-19 pandemic.
An increase in endovascular interventions (52% in 2021) and a decrease in microsurgical procedures (48% in 2021).
Postoperative mortality rates declined (5.6% in 2021 vs. 6.3% in 2017), and surgeries during the acute hemorrhage period increased (70% in 2021).

Impact:

The study highlights a positive trend of reduced mortality despite fewer interventions, suggesting improved treatment efficacy.
Increased adoption of endovascular techniques and revascularization signifies advancements in neurosurgical practice.
A rise in high-volume centers performing over 50 annual interventions indicates a potential consolidation of expertise.