Translucent appearance of middle cerebral artery bifurcation aneurysms is a risk factor for intraoperative aneurysm rupture during clipping.

Translucent appearance of middle cerebral artery bifurcation aneurysms is a risk factor for intraoperative aneurysm rupture during clipping.

World Neurosurg. 2017 Feb 08;:

Authors: Chen XL, Chen Y, Ma L, Burkhardt JK, Wardell T, Wang C, Guo G, Wang S, Zhao YL

Abstract
INTRODUCTION: The rupture rate of unruptured intracranial aneurysms (UIA) is influenced by certain angioarchitectural and hemodynamic characteristics. Recently the translucent appearance of aneurysm was described as a possible risk factor for aneurysm rupture. In this study, we investigate the intraoperative rupture risk of surgically clipped unruptured translucent aneurysms (TA).
METHOD: Clinical and radiological data of microsurgically treated unruptured MCA bifurcation aneurysm between 2013 and 2015 was collected and analyzed. Aneurysms were divided into TA as defined as > 90% reddish pigmentation appearance of the aneurysm wall or non-TA (NTA) according to the observation under microscope by a single neurosurgeon. Parameters were analyzed using uni- and multivariate statistical analysis.
RESULT: A total of 41 unruptured MCA bifurcation aneurysms were included in the analysis and 68.2% (28/41) were defined as TA. The univariate analysis showed that aneurysm characteristics (Dmax, Wmax, height and lower size ratio (SR)) that were small in nature were associated with TAs. TAs were associated with intraoperative rupture (28.6% vs 0%, p=0.04) Multivariate logistic regression analysis found that the lower SR is the independent risk factor for TAs.
CONCLUSION: The results demonstrate that a lower SR correlates with TA in the MCA bifurcation and the thinner wall of TA causes intraoperative rupture more likely. These results provide important information on the fragility of TAs and might influence the treatment decisions in unruptured MCA bifurcation aneurysms with lower SR.

PMID: 28189862 [PubMed - as supplied by publisher]

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