The value of intraoperative angiography in surgery of intracranial aneurysms: a prospective study in 126 patients |
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Authors: | Popadić A Witzmann A Amann T Doringer W Fleisch M Häfel C Hergan K Längle M |
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Affiliation: | (1) Department of Neurosurgery, Landeskrankenhaus Feldkirch, Carinagasse 47–49, 6800 Feldkirch, Austria e-mail: dr.a.popadic@aon.at Tel.: + 43-55-2 23 03-0 Fax: + 43-55-2 23 03-75 15, AT;(2) Department of Radiology, Landeskrankenhaus Feldkirch, Carinagasse 47–49, 6800 Feldkirch, Austria, AT |
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Abstract: | The value of intraoperative digital subtraction angiography in surgery for intracranial aneurysms, the benefits and cost-effectiveness are a matter of discussion. We prospectively studied 126 patients with 144 aneurysms, most on the anterior intracranial circulation, who underwent clipping and intraoperative angiography. Follow-up was 28.4 ± 13.1 months. We tried to work out the indications for intraoperative angiography of the anterior circulation and its cost-effectiveness. In 10.3 % of patients (9 % per aneurysm) unexpected findings were shown by intraoperative angiography: inadequately clipped aneurysms in 10 (7.9 %), a completely unclipped aneurysm in one (0.8 %) and occluded major arteries in two (1.6 %). A broad neck was a variable of statistical significance for inadequate clipping or stenosis or occlusion of an adjacent vessel. There was a strong trend for aneurysms more than 15 mm in diameter to be “risky”. Their site was not a predictive factor. We believe that intraoperative angiography is indicated in surgery not only on large and giant aneurysms, but also broad-based aneurysms of the anterior cerebral circulation regardless of their size. It is cost-effective compared to postoperative angiography. The rate of stroke in our hands was 0.8 %. Received: 19 January 2000 Accepted: 3 November 2000 |
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Keywords: | Aneurysm intracranial Surgery Digital subtraction angiography |
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