Complications of Anterior Circulation Aneurysm Surgery

Lee, Kyu Chang; Lee, Jae Whan

Abstract

In this invited review article for the annual continuing medical education, the authors described their experiences regarding the complications and their prevention in surgery on aneurysms of the anterior circulation. The authors reviewed the database as sources for identifying and analyzing patients. From September 1975 to June 2001, among total of 2,270 patients treated for intracranial aneurysms, 2,089 patients were treated by surgery. The frequencies of favorable (good, fair) and unfavorable (poor, dead) outcome were 1,839 (92.3%) and 153 (7.7%), respectively. Of the 153 patients with unfavorable outcome, 25 patients were due to the surgical complications. The complications were vascular occlusion (10), venous infarction (7), intraoperative premature rupture (3), rebleeding due to incomplete clipping (2), bilateral epidural hematoma (1), and unknown (2). We concluded that the surgeon's experience, thorough knowledge of microsurgical anatomy, modern neuroprotection method, perioperative neurosurgical intensive care, computerized neurophysiologic monitoring, and clever surgical clips would be necessary for prevention of the surgical complications in the treatment of the intracranial aneurysms.