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Neurosurgery. 2010 Sep;67(3):755-61; discussion 761. doi: 10.1227/01.NEU.0000378025.33899.26.

Outcome for middle cerebral artery aneurysm surgery.

Author information

1
Australian School of Advanced Medicine, Level 1, 3 Dow Corning, Innovation Rd, Macquarie University, NSW 2109, Australia. michael.morgan@mq.edu.au

Abstract

OBJECTIVE:

To assess in depth the variables contributing to adverse surgical outcome for repair of unruptured middle cerebral artery aneurysms.

METHODS:

Prospectively collected data between October 1989 and June 2009 were examined retrospectively. Putative risk factors were investigated with univariate and multivariate logistic regression analyses.

RESULTS:

In this study, 263 patients (339 aneurysms) underwent surgical clipping in 280 operations for unruptured middle cerebral artery aneurysms. The overall surgical mortality and morbidity rate was 5% (95% confidence interval [CI], 2.9-8.3). Multivariate logistic analysis of risk factors revealed that age and aneurysm size were independent predictors of surgical outcome. Patients < 60 years of age with an aneurysm < or = 12 mm constituted a low-risk group with a procedure-related combined mortality and morbidity of 0.6% (95% CI, 0-3.8). Patients < 60 years of age with an aneurysm > 12 mm had a procedure-related combined mortality and morbidity of 7.4% (95% CI, 1-24.5). Patients > or = 60 years of age with an aneurysm of < or = 12 mm had a procedure-related combined mortality and morbidity of 9.3% (95% CI, 4.3-18.3). Patients > or = 60 years of age with an aneurysm > 12 mm had a procedure-related combined mortality and morbidity of 22.2% (95% CI, 8.5-45.8).

CONCLUSION:

Age and size of aneurysm were the only 2 independent predictors of surgical outcome.

[Indexed for MEDLINE]

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