ruptured_anterior_communicating_artery_aneurysm_outcome

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ruptured_anterior_communicating_artery_aneurysm_outcome [2022/08/16 11:47] administradorruptured_anterior_communicating_artery_aneurysm_outcome [2022/08/16 11:50] (current) – [Clinical outcomes of microvascular clipping compared to endovascular coiling] administrador
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 Proper management of preoperative [[intraventricular hemorrhage]], A1 hypoplasia, and intensive care for postoperative [[brain]] [[infarction]] are warranted for improved surgical outcomes in patients with ruptured AComA aneurysm undergoing surgical clipping Proper management of preoperative [[intraventricular hemorrhage]], A1 hypoplasia, and intensive care for postoperative [[brain]] [[infarction]] are warranted for improved surgical outcomes in patients with ruptured AComA aneurysm undergoing surgical clipping
 ((Sungkaro K, Tunthanathip T, Taweesomboonyat C, Kaewborisutsakul A. Surgical outcomes of patients after treatment of ruptured anterior communicating artery aneurysms: "real-world" evidence from southern Thailand. Chin Neurosurg J. 2021 Oct 2;7(1):42. doi: 10.1186/s41016-021-00259-9. PMID: 34598732; PMCID: PMC8487142.)). ((Sungkaro K, Tunthanathip T, Taweesomboonyat C, Kaewborisutsakul A. Surgical outcomes of patients after treatment of ruptured anterior communicating artery aneurysms: "real-world" evidence from southern Thailand. Chin Neurosurg J. 2021 Oct 2;7(1):42. doi: 10.1186/s41016-021-00259-9. PMID: 34598732; PMCID: PMC8487142.)).
-===== Clinical outcomes of microvascular clipping compared to endovascular coiling =====+===== Ruptured anterior communicating artery aneurysm outcome of microvascular clipping compared to endovascular coiling =====
  
-Anterior communicating artery aneurysm, attention should be paid not only to the anatomical characteristics of the aneurysm itself but also to the adjacent important blood vessels and perforating arteries; therefore, both surgical clipping and endovascular embolization are serious challenges for neurosurgeons. No matter which treatment is chosen, it is necessary to determine the structure of the Anterior communicating artery and its perforating arteries as well as whether there is a fenestration deformity of the Anterior communicating artery and the relationship between bilateral A1-A2 before surgery. The shape and size of the aneurysm itself and its location relative to adjacent blood vessels also need to be considered to better complete the procedure, and this is especially true for microsurgical clipping. Clarifying the anatomy before surgery is helpful for better selecting the surgical approach and surgical side, which could affect the intraoperative exposure of the aneurysm and adjacent arteries, the surgical difficulty, the resection rate, and the postoperative complications. Therefore, starting with Anterior communicating artery aneurysms and their adjacent structures and variations +[[Ruptured anterior communicating artery aneurysm outcome of microvascular clipping compared to endovascular coiling]]
-((Chen J, Li M, Zhu X, Chen Y, Zhang C, Shi W, Chen Q, Wang Y. Anterior Communicating Artery Aneurysms: Anatomical Considerations and Microsurgical Strategies. Front Neurol. 2020 Sep 8;11:1020. doi: 10.3389/fneur.2020.01020. Erratum in: Front Neurol. 2020 Nov 20;11:620226. PMID: 33013671; PMCID: PMC7509403.)) +
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-[[Frontal lobe]] and [[recurrent artery of Heubner]] infarctions are more common after surgical clipping of ruptured anterior communicating artery aneurysms, and are associated with poorer clinical outcomes at discharge 
-((Heit JJ, Ball RL, Telischak NA, Do HM, Dodd RL, Steinberg GK, Chang SD, Wintermark M, Marks MP. Patient Outcomes and Cerebral Infarction after Ruptured Anterior Communicating Artery Aneurysm Treatment. AJNR Am J Neuroradiol. 2017 Nov;38(11):2119-2125. doi: 10.3174/ajnr.A5355. Epub 2017 Sep 7. PMID: 28882863; PMCID: PMC7963583.)) 
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-There was no difference in age between the treatment modalities. Risks of complications are present and specific for both modalities 
-((Navrátil O, Ďuriš K, Juráň V, Svoboda K, Hustý J, Hovorka E, Neuman E, Mrlian A, Smrčka M. Current Treatment of Anterior Communicating Artery Aneurysms: Single Center Study. Brain Sci. 2020 Jul 31;10(8):501. doi: 10.3390/brainsci10080501. PMID: 32751951; PMCID: PMC7465251.)). 
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-The [[clinical outcome]]s of [[microsurgical clipping]] versus [[endovascular coiling]] have been reported in [[systematic review]]s for other [[intracranial aneurysm locations]], including [[middle cerebral artery aneurysm]] and [[posterior communicating artery aneurysm]]s. A [[systematic review]] is necessary to evaluate the functional, angiographic, and safety outcomes of [[endovascular management]] versus [[microsurgical clipping]] for [[treatment]] [[guideline]]s. 
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-[[Inclusion criteria]]: Patients aged 18 years and over with a [[ruptured anterior communicating artery aneurysm]] will be included. Patients may have intracranial aneurysms in other locations; however, they will only be included if a ruptured anterior communicating artery aneurysm has occurred and only if that aneurysm has been treated. Interventions of interest are [[microsurgical clipping]] compared to [[endovascular treatment]]. 
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-Methods: The following [[database]]s will be searched: [[PubMed]], [[Embase]], [[Scopus]], and [[Cochrane Central Register of Controlled Trials]]. Experimental, [[quasi-experiment]]al, and [[analytical observational]] [[studies]] will be considered. Studies in all languages will be included if they can be translated. Two independent [[reviewer]]s will retrieve and assess relevant studies using [[JBI’s critical appraisal tools]]. Extracted [[data]] will include [[Glasgow Outcome Scale]]/[[Modified Rankin Score]], angiographic [[occlusion]], [[aneurysm recurrence]], intra-operative [[thromboembolic event]] rates, post-operative complications, and post-operative aneurysm recurrence rates. Studies will, where possible, be pooled using statistical [[meta-analysis]]. Outcomes assessed will include functional status, angiographic occlusion rates, incidence of aneurysm recurrence, and [[safety]] of treatment 
-((Nowicki J, Harding M, Aromataris E. Clinical outcomes of microvascular clipping compared to endovascular coiling for ruptured anterior communicating artery aneurysms: a systematic review protocol. JBI Evid Synth. 2022 Aug 1;20(8):2032-2039. doi: 10.11124/JBIES-21-00332. PMID: 35971201.)). 
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