Role of temporary arterial occlusion in subarachnoid hemorrhage outcomes: a prospective cohort study

Yoshikawa, Marcia Harumy; Rabelo, Nícollas Nunes; Telles, João Paulo Mota; Pipek, Leonardo Zumerkorn; Barbosa, Guilherme Bitencourt; Barbato, Natália Camargo; Coelho, Antônio Carlos Samaia da Silva; Teixeira, Manoel Jacobsen; Figueiredo, Eberval Gadelha

doi:10.1590/acb387923

Acta Cir. Bras.

2023

DOI: 10.1590/acb387923

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Role of temporary arterial occlusion in subarachnoid hemorrhage outcomes: a prospective cohort study

Marcia Harumy Yoshikawa,

Nícollas Nunes Rabelo,

João Paulo Mota Telles

et al.

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2024

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Cited by 1 publication

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Under recognized yet a clinically relevant impact of aneurysm location in Distal Anterior Cerebral Artery (DACA) aneurysms: insights from a contemporary surgical experience

Haldar,

Das,

Kanjilal

et al. 2024

Preprint

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Background Aneurysms of the distal anterior cerebral artery (DACA) are rare but challenging. Even though it is known that aneurysm location on the DACA territory has treatment considerations, the literature is unclear about its clinical and prognostic role. Material and methods Our surgical experience over the last 5 years were reviewed to compare the clinical, operative, and outcome characteristics between aneurysms located below the mid portion of the genu of the corpus callosum (called proximal aneurysms) to those distal to this point (called distal aneurysms). A prognostic factor analysis was done using uni and multivariate analysis. Results A total of 34 patients were treated (M:F = 1:2.3). The distal group significantly showed poor clinical grade at presentation (n = 9, 47.4%) in contrast to (n = 2, 13.3%) proximal aneurysms (p = 0.039). Despite an overall tendency for a delayed functional improvement in these patients, the results were mainly due to favorable outcomes in the proximal group (favourable functional outcomes at discharge and at last follow-up being 80% and 86.7% respectively). On multivariate analysis, only WFNS grade (> 2) at presentation (OR = 13.75; 95CI = 1.2–157.7) (p = 0.035) and application of temporary clips (AOR = 34.32; 95CI = 2.59–454.1) (p = 0.007), both of which were more in the distal group, independently predicted a poor long term functional outcome. Conclusion Aneurysm location impacts preoperative clinical grade and affects intraoperative aneurysm rupture risk rate as well as temporary clipping requirement. The combination of these leads to worse short and long-term functional outcomes in distal DACA aneurysms.

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Under recognized yet a clinically relevant impact of aneurysm location in Distal Anterior Cerebral Artery (DACA) aneurysms: insights from a contemporary surgical experience

Haldar,

Das,

Kanjilal

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

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Role of temporary arterial occlusion in subarachnoid hemorrhage outcomes: a prospective cohort study

Cited by 1 publication

References 29 publications

Under recognized yet a clinically relevant impact of aneurysm location in Distal Anterior Cerebral Artery (DACA) aneurysms: insights from a contemporary surgical experience

Under recognized yet a clinically relevant impact of aneurysm location in Distal Anterior Cerebral Artery (DACA) aneurysms: insights from a contemporary surgical experience

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