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Angiographically unrecognized microaneurysms: intraoperative observation and operative technique
H Karasawa1, H Matsumoto, H Naito
1Department of Neurosurgery, Funabashi Municipal Medical Center, Chiba, Japan.
Acta Neurochirurgica
|January 1, 1997
Summary
Angiographically unrecognized microaneurysms (AUMs) are often found during intracranial aneurysm surgery. Surgeons must consider AUMs, as they can be hidden and require specific clipping techniques for safe treatment.
Area of Science:
- Neurosurgery
- Vascular Surgery
- Neuroradiology
Background:
- Intracranial aneurysms are common vascular abnormalities.
- Microaneurysms (AUMs) can be associated with larger aneurysms.
- Pre-operative imaging may not always detect small AUMs.
Purpose of the Study:
- To analyze intra-operative findings of angiographically unrecognized microaneurysms (AUMs).
- To evaluate clipping techniques for AUMs during intracranial aneurysm surgery.
- To highlight the importance of recognizing AUMs in surgical planning.
Main Methods:
- Analysis of 20 operated cases with angiographically unrecognized microaneurysms (AUMs).
- Intra-operative observation and documentation of AUM characteristics and location.
- Evaluation of various clipping techniques and wrapping/coating methods used for AUMs.
Main Results:
- 3.7% incidence of asymptomatic, incidental AUMs (≤2 mm) in operated intracranial aneurysm patients.
- 60% of AUMs were found on parent arteries of ruptured aneurysms.
- Common reasons for missed AUMs include anatomical masking and misinterpretation as aneurysm blebs.
Conclusions:
- Microaneurysms (AUMs) are frequently encountered during intracranial aneurysm surgery.
- Specific clipping techniques and adjuncts like wrapping are effective for AUM treatment.
- Neurosurgeons and neuroradiologists should inform patients about the potential presence of AUMs.