1. Clipping of ruptured intracranial aneurysms in a hybrid room environment-a case-control study
- Author
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Max Jägersberg, Zsolt Kulcsar, Ivan Radovanovic, Karl Lothard Schaller, Philippe Bijlenga, and Philipp Dammann
- Subjects
Adult ,Male ,medicine.medical_specialty ,Microsurgery ,Operating Rooms ,medicine.medical_treatment ,Medizin ,Aneurysm, Ruptured ,ddc:616.0757 ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Aneurysm ,Postoperative Complications ,Occlusion ,medicine ,Humans ,Neuroradiology ,Aged ,medicine.diagnostic_test ,business.industry ,Interventional radiology ,Intracranial Aneurysm ,Clipping (medicine) ,Middle Aged ,medicine.disease ,ddc:616.8 ,Surgery ,Cerebral Angiography ,Case-Control Studies ,Angiography ,Cohort ,Female ,Neurology (clinical) ,Radiology ,business ,030217 neurology & neurosurgery ,Cerebral angiography - Abstract
Hybrid room treatment (HRT) provides the surgeon immediate intraoperative angiography control of aneurysm occlusion and vessel patency. Since it is relatively resource demanding, in clinical routine HRT is reserved for elective cases. However, since its introduction in our department in 2008, several random cases of ruptured intracranial aneurysms (IAs) have been treated in the HR. This study aims to compare the clinical and radiological outcomes of these cases with cases treated conventionally using a matched pair analysis. Twenty (20%) consecutive patients with ruptured IA treated by microsurgical clipping in the HR between 2009 and 2015 were retrospectively matched with “conventionally” (C) treated patients (overall n = 101). Clinical and radiological outcome variables were assessed and compared. Despite a trend in favor of the HR group, no significant difference between both matched groups (HR vs. C) could be demonstrated regarding the functional outcome (upper/lower good recovery 16/20 vs. 17/20, p > 0.05), frequency of clipping-related vascular insults on CT scans (0/20 vs. 3/20, p > 0.05), aneurysm remnant rate on postoperative angiography (1/20 vs. 4/20, p > 0.05) and retreatment rate (0/20 vs. 1/20, p > 0.05). When cumulating all outcome events by a scoring system, however, the HR cohort showed a significantly lower occurrence of events (p
- Published
- 2017