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Journal of Korean Neurosurgical Society > Volume 43(3); 2008 > Article
Journal of Korean Neurosurgical Society 2008;43(3): 131-134.
doi: https://doi.org/10.3340/jkns.2008.43.3.131
Analysis of Clip-induced Ischemic Complication of Anterior Choroidal Artery Aneurysms.
Min Soo Cho, Min Su Kim, Chul Hoon Chang, Sang Woo Kim, Seong Ho Kim, Byung Yon Choi
Department of Neurosurgery, College of Medicine, Yeungnam University, Daegu, Korea. bychoi@med.yu.ac.kr
ABSTRACT
OBJECTIVE:
The surgical approach is typically similar to those used for other supraclinoid internal carotid artery (ICA) lesions. However, the surgical clipping of this aneurysm is complicated and as a result, can result in postoperative ischemic complications. We studied to clarify the clip-induced ischemic complication risk of AChA aneurysm and to get the benefits for helping decision making.
METHODS:
We retrospectively investigated 53 cases (4.0%) of AchA aneurysm treated surgically. We divided the AChA aneurysm to 3 subtype according to the origin of aneurysmal neck; A type originating from the AChA itself, J type from junction of AChA and ICA, and I type from the ICA itself. We evaluated brain CT about 1 week post-operative day to confirm the low density in AChA territory.
RESULTS:
Ruptured aneurysm was 26 cases and unruptured aneurysm 27 cases. The aneurysmal subtype of A, J, and I was 13, 17, and 23 cases. Of the 53 cases who performed surgical neck clipping, twelve (22.6%) had postoperative AChA distribution infarcts. Increased infarct after neck clipping had statistic significance in non-I subtype (p=0.005).
CONCLUSION:
It is easy to classify as "easy" surgery. But surgery for AChA aneurysms carries with it a significant risk of postoperative stroke. Don't always stick to clipping only, especially in non-I type of incidental small aneurysm, which has high risk of post-clip ischemic complications.
Key Words: Anterior choroidal artery infarction; Clip; Intracranial aneurysm
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