Intra-aneurysmal contrast agent stasis during intraoperative digital subtraction angiography may predict long-term occlusion after clipping.
Intracranial aneurysm
Intraoperative DSA
Occlusion
Remnant
Spontaneous
Thrombosis
Journal
Acta neurochirurgica
ISSN: 0942-0940
Titre abrégé: Acta Neurochir (Wien)
Pays: Austria
ID NLM: 0151000
Informations de publication
Date de publication:
30 Jul 2024
30 Jul 2024
Historique:
received:
04
04
2024
accepted:
05
06
2024
medline:
30
7
2024
pubmed:
30
7
2024
entrez:
30
7
2024
Statut:
epublish
Résumé
The routine use of intraoperative digital subtraction angiography (iDSA) increases detection of intracranial aneurysm (IA) remnants after microsurgical clipping. Spontaneous thrombosis of IA remnants after clipping is considered a rare phenomenon. We analyse iDSA characteristics to find predictors for IA remnant thrombosis. IA with intraoperative detection of a remnant after clipping were identified and divided into remnants experiencing spontaneous thrombosis, and remnants with long-term patency and/or remnant growth. Angiographic features of iDSA were analysed and compared between the two groups. Of 37 IAs with intraoperative remnant on 3D-iDSA, five sustained a spontaneous remnant thrombosis and remained occluded in long-term follow-up. In all five cases, iDSA revealed delayed inflow and consequent stasis of the contrast agent until the late venous phase. On the other hand, in all cases with persistent long-term IA remnants (n = 32) iDSA demonstrated timely arterial contrast inflow and wash-out without stasis of intra-aneurysmal contrast agent. Contrast stasis in IA remnants during iDSA appears to predict long-term IA occlusion, indicating that clip correction manoeuvres or even attempted endovascular treatment of the remnant IA may be avoided in these patients.
Identifiants
pubmed: 39078422
doi: 10.1007/s00701-024-06162-3
pii: 10.1007/s00701-024-06162-3
doi:
Substances chimiques
Contrast Media
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
309Informations de copyright
© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.
Références
Akyüz M, Tuncer R, Yilmaz S, Sindel T (2004) Angiographic follow-up after surgical treatment of intracranial aneurysms. Acta Neurochir 146:245–250 discussion 250. https://doi.org/10.1007/s00701-003-0206-z
doi: 10.1007/s00701-003-0206-z
pubmed: 15015046
Brown MA, Parish J, Guandique CF, Payner TD, Horner T, Leipzig T, Rupani KV, Kim R, Bohnstedt BN, Cohen-Gadol AA (2017) A long-term study of durability and risk factors for aneurysm recurrence after microsurgical clip ligation. J Neurosurg 126:819–824. https://doi.org/10.3171/2016.2.Jns152059
doi: 10.3171/2016.2.Jns152059
pubmed: 27128583
Burkhardt JK, Chua MHJ, Weiss M, Do ASS, Winkler EA, Lawton MT (2017) Risk of Aneurysm residual regrowth, recurrence, and de Novo Aneurysm formation after microsurgical clip occlusion based on follow-up with catheter angiography. World Neurosurg 106:74–84. https://doi.org/10.1016/j.wneu.2017.06.110
doi: 10.1016/j.wneu.2017.06.110
pubmed: 28648910
Chow MM, Thorell WE, Rasmussen PA (2005) Aneurysm regression after coil embolization of a concurrent aneurysm. AJNR Am J Neuroradiol 26:917–921
pubmed: 15814946
pmcid: 7977086
David CA, Vishteh AG, Spetzler RF, Lemole M, Lawton MT, Partovi S (1999) Late angiographic follow-up review of surgically treated aneurysms. J Neurosurg 91:396–401. https://doi.org/10.3171/jns.1999.91.3.0396
doi: 10.3171/jns.1999.91.3.0396
pubmed: 10470813
Fandino J, Taussky P, Marbacher S, Muroi C, Diepers M, Fathi AR, Remonda L (2013) The concept of a hybrid operating room: applications in cerebrovascular surgery. Acta Neurochir Supplement 115:113–117. https://doi.org/10.1007/978-3-7091-1192-5_24
doi: 10.1007/978-3-7091-1192-5_24
Goksu E, Korkmaz E, Akyuz M, Ozgur O, Sindel T, Tuncer R (2015) The analysis of long-term follow-up screening in patients with surgically treated intracranial aneurysms. Turk Neurosurg 25:404–409. https://doi.org/10.5137/1019-5149.Jtn.10299-14.3
doi: 10.5137/1019-5149.Jtn.10299-14.3
pubmed: 26037180
Grüter BE, Wanderer S, Andereggen L, Tortora A, Gruber P, Anon J, Diepers M, Schubert G, Remonda L, Marbacher S (2023) Incidence and outcome of peri-interventional Vasospasm during Endovascular or Microsurgical Treatment of Unruptured Intracranial aneurysms. Neurosurgery 92:599–606. https://doi.org/10.1227/neu.0000000000002253
doi: 10.1227/neu.0000000000002253
pubmed: 36512826
Jabbarli R, Pierscianek D, Wrede K, Dammann P, Schlamann M, Forsting M, Müller O, Sure U (2016) Aneurysm remnant after clipping: the risks and consequences. J Neurosurg 125:1249–1255. https://doi.org/10.3171/2015.10.Jns151536
doi: 10.3171/2015.10.Jns151536
pubmed: 26871206
Kivelev J, Tanikawa R, Noda K, Hernesniemi J, Niemelä M, Takizawa K, Tsuboi T, Ohta N, Miyata S, Oda J, Tokuda S, Kamiyama H (2016) Open surgery for recurrent intracranial aneurysms: techniques and long-term outcomes. World Neurosurg 96:1–9. https://doi.org/10.1016/j.wneu.2016.07.091
doi: 10.1016/j.wneu.2016.07.091
pubmed: 27506404
Marbacher S, Diepers M, Kahles T, Nedeltchev K, Remonda L, Fandino J (2016) Interdisciplinary decision-making and treatment of intracranial aneurysms in the era of complementary microsurgical and endovascular techniques. Swiss Med Wkly 146:w14372. https://doi.org/10.4414/smw.2016.14372
doi: 10.4414/smw.2016.14372
pubmed: 27878787
Marbacher S, Mendelowitsch I, Gruter BE, Diepers M, Remonda L, Fandino J (2018) Comparison of 3D intraoperative digital subtraction angiography and intraoperative indocyanine green video angiography during intracranial aneurysm surgery. J Neurosurg 131:64–71. https://doi.org/10.3171/2018.1.JNS172253
doi: 10.3171/2018.1.JNS172253
pubmed: 30004279
Marbacher S, Bircher B, Vogt DR, Diepers M, Remonda L, Fandino J (2021) Periinterventional Vasospasm in patients with Aneurysmal Subarachnoid Hemorrhage predicts an unfavorable clinical course. Neurosurg Open 2. https://doi.org/10.1093/neuopn/okaa021
doi: 10.1093/neuopn/okaa021
Marbacher S, Halter M, Vogt DR, Kienzler JC, Magyar CTJ, Wanderer S, Anon J, Diepers M, Remonda L, Fandino J (2021) Value of three-Dimensional Digital Subtraction Angiography for detection and classification of Intracranial Aneurysm remnants after clipping. Oper Neurosurg (Hagerstown). https://doi.org/10.1093/ons/opab087
doi: 10.1093/ons/opab087
pubmed: 34171916
Marbacher S, Gruter BE, Wanderer S, Andereggen L, Cattaneo M, Trost P, Gruber P, Diepers M, Remonda L, Steiger HJ (2022) Risk of intracranial aneurysm recurrence after microsurgical clipping based on 3D digital subtraction angiography. J Neurosurg 1–7. https://doi.org/10.3171/2022.5.JNS22424
Owen CM, Montemurro N, Lawton MT (2015) Microsurgical Management of Residual and recurrent aneurysms after coiling and clipping: an experience with 97 patients. Neurosurgery 62(Suppl 1):92–102. https://doi.org/10.1227/NEU.0000000000000791
doi: 10.1227/NEU.0000000000000791
pubmed: 26181926
Piao J, Luan T, Qu L, Yu J (2021) Intracranial post-clipping residual or recurrent aneurysms: current status and treatment options (review). Med Int (Lond) 1:1. https://doi.org/10.3892/mi.2021.1
doi: 10.3892/mi.2021.1
pubmed: 36698683
Raabe A, Seidel K (2016) Prevention of ischemic complications during aneurysm surgery. J Neurosurg Sci 60:95–103
pubmed: 26606432
Raabe A, Nakaji P, Beck J, Kim LJ, Hsu FP, Kamerman JD, Seifert V, Spetzler RF (2005) Prospective evaluation of surgical microscope-integrated intraoperative near-infrared indocyanine green videoangiography during aneurysm surgery. J Neurosurg 103:982–989. https://doi.org/10.3171/jns.2005.103.6.0982
doi: 10.3171/jns.2005.103.6.0982
pubmed: 16381184
Spiessberger A, Vogt DR, Fandino J, Marbacher S (2019) Formation of intracranial de novo aneurysms and recurrence after neck clipping: a systematic review and meta-analysis. J Neurosurg 132:456–464. https://doi.org/10.3171/2018.10.Jns181281
doi: 10.3171/2018.10.Jns181281
pubmed: 30797217
Tsimpas A, Ashley WW, Germanwala AV (2016) Spontaneous regression of intracranial aneurysm following remote ruptured aneurysm treatment with pipeline stent assisted coiling. J Neurointerventional Surg 8:e39. https://doi.org/10.1136/neurintsurg-2015-011931.rep
doi: 10.1136/neurintsurg-2015-011931.rep
Tsutsumi K, Ueki K, Morita A, Usui M, Kirino T (2001) Risk of aneurysm recurrence in patients with clipped cerebral aneurysms: results of long-term follow-up angiography. Stroke 32:1191–1194. https://doi.org/10.1161/01.str.32.5.1191
doi: 10.1161/01.str.32.5.1191
pubmed: 11340232
Vivanco-Suarez J, Sioutas GS, Matache IM, Muhammad N, Salem MM, Kandregula S, Jankowitz BT, Burkhardt JK, Srinivasan VM (2023) Intraoperative angiography during neurosurgical procedures on patients in prone, three-quarters prone, and park-bench positions: tertiary single-center experience with systematic review and meta-analysis. J Neurointerventional Surg. https://doi.org/10.1136/jnis-2022-020035
doi: 10.1136/jnis-2022-020035