Retrospective Study of 32 Kissing Aneurysms: Radiological Detection, Microsurgical Clipping, and Functional Outcomes

Area of Science:

• Neurosurgery
• Vascular Neurology
• Medical Imaging

Background:

• Kissing aneurysms (KA) are rare intracranial aneurysms with adjacent, separately originating domes.
• Their unique morphology can be misdiagnosed as a single aneurysm, complicating treatment.
• Distinguishing KA preoperatively is vital, especially in ruptured cases.

Purpose of the Study:

• To analyze clinical, radiological, and surgical features of 32 patients with KA treated microsurgically.
• To review literature for contextualizing findings on KA management.

Main Methods:

• Retrospective observational study of KA patients treated with microsurgical clipping (2004-2024).
• Utilized CT, CT angiography, and digital subtraction angiography for diagnosis.
• Tailored surgical approaches based on aneurysm location and rupture status.
• Assessed functional outcomes using the modified Rankin scale (mRS).

Main Results:

• KA represented 2.3% of treated aneurysms; most common at the posterior communicating artery-anterior choroidal artery segment.
• Preoperative identification achieved in 87.5% of cases.
• Favorable outcomes (mRS 0-2) in 87.5% of patients; intraoperative rupture occurred in 25%.

Conclusions:

• KA present diagnostic and surgical challenges due to complex anatomy and rupture risk.
• Microsurgical clipping demands meticulous dissection, vascular control, and intraoperative imaging.
• Age is a potential risk factor for rupture, necessitating vigilant monitoring in older patients.