Universität zu Köln

Goertz, Lukas, Pflaeging, Muriel, Hamisch, Christina, Kabbasch, Christoph ORCID: 0000-0003-3712-2258, von Spreckelsen, Niklas ORCID: 0000-0002-9873-1711, Laukamp, Kai, Pennig, Lenhard, Wetzel, Christian, Brinker, Gerrit, Goldbrunner, Roland and Krischek, Boris (2020). Identifying Predictors for Aneurysm Remnants After Clipping by Morphometric Analysis and Proposal of a Novel Risk Score. World Neurosurg., 136. S. E300 - 10. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1878-8769

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Abstract

OBJECTIVE: Although the risk of aneurysm remnants after microsurgical clipping is generally low, complete aneurysm occlusion is not always guaranteed. We performed a morphometric analysis of intracranial aneurysms to identify predictors for aneurysm remnants and to propose a novel risk score. METHODS: This is a retrospective, single-center analysis of consecutive patients with ruptured and unruptured aneurysms who underwent microsurgical clipping and postoperative digital subtraction angiography between 2010 and 2018. Based on preoperative rotational angiography, distinct morphologic aneurysm characteristics were determined and correlated with postoperative angiographic results. Factors predictive in the univariate and multivariate analyses were determined to establish a risk score for postoperative remnants after aneurysm clipping. RESULTS: Among 140 patients with 166 clipped aneurysms, aneurysm remnants were present in 19.9%. In the multivariate analysis, ruptured aneurysm status (odds ratio [OR] 7.8; 95% confidence interval [CI], 1.7-36; P < 0.01) and increased aspect ratio (OR, 1.9; 95% CI, 1.0-4.0; P = 0.07) were associated with postoperative aneurysm remnants. Anterior communicating artery location (P = 0.02), internal carotid artery location (P = 0.06), increased aneurysm inclination angle (P < 0.01), and irregular aneurysm shape (P = 0.07) were further predictors for aneurysm remnants in the univariate analysis. These factors were weighted and included into a risk sum score for postoperative aneurysm remnants (range, 0-8 points), which performed with good accuracy (area under the curve = 0.807). CONCLUSIONS: After external validation of the proposed risk score, it could help identify cases requiring angiographic control after aneurysm surgery.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Goertz, Lukas UNSPECIFIED UNSPECIFIED UNSPECIFIED Pflaeging, Muriel UNSPECIFIED UNSPECIFIED UNSPECIFIED Hamisch, Christina UNSPECIFIED UNSPECIFIED UNSPECIFIED Kabbasch, Christoph UNSPECIFIED orcid.org/0000-0003-3712-2258 UNSPECIFIED von Spreckelsen, Niklas UNSPECIFIED orcid.org/0000-0002-9873-1711 UNSPECIFIED Laukamp, Kai UNSPECIFIED UNSPECIFIED UNSPECIFIED Pennig, Lenhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Wetzel, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Brinker, Gerrit UNSPECIFIED UNSPECIFIED UNSPECIFIED Goldbrunner, Roland UNSPECIFIED UNSPECIFIED UNSPECIFIED Krischek, Boris UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-339616
DOI:	10.1016/j.wneu.2019.12.158
Journal or Publication Title:	World Neurosurg.
Volume:	136
Page Range:	S. E300 - 10
Date:	2020
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1878-8769
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language RUPTURED INTRACRANIAL ANEURYSMS; ENDOVASCULAR COILING; ANGIOGRAPHY; SURGERY; MORPHOLOGY; TRIAL; ISAT Multiple languages Clinical Neurology; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/33961