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Aneurysm reinforcement in the anterior circulation
1Section of Neurosurgery, University of Puerto Rico, San Juan 00936, USA.
Surgical Neurology
|November 14, 1997
Summary
Reinforcing unclippable aneurysms with muslin and ethyl 2-cyanoacrylate reduces rebleeding risk, especially in the first six months. This method offers a viable alternative when direct clipping is not possible.
Area of Science:
- Neurosurgery
- Vascular Surgery
- Medical Devices
Background:
- Surgical clipping is the primary treatment for aneurysms.
- Unclippable aneurysms face high rebleeding risks.
- Aneurysm reinforcement offers a potential alternative for complex cases.
Purpose of the Study:
- To evaluate the safety and efficacy of muslin and ethyl 2-cyanoacrylate reinforcement for aneurysms.
- To assess the rebleeding rate in patients with unclippable or partially clipped aneurysms.
Main Methods:
- A cohort of 19 patients with aneurysms treated with reinforcement was analyzed.
- Mean follow-up was 60 months.
- Yearly rebleeding risk was calculated and compared to natural history.
Main Results:
- Reinforcement was used for wide-based or complex aneurysms.
- Primary reinforcement showed a 2.95% yearly rebleeding risk.
- Supplementing clips resulted in no rebleeding; overall ruptured aneurysm risk was 1.94% yearly.
- No complications were observed.
Conclusions:
- Muslin and ethyl 2-cyanoacrylate reinforcement provides protection for difficult-to-clip aneurysms.
- It is inferior to clipping but reduces early rebleeding risk.
- Longer follow-up is needed to assess long-term efficacy against natural history.