Surgical Experiences of 2,178 Cases of Intracranial Aneurysms

Sim, Jae Hong; Kim, Soo Chun; Jung, Yong Tae; Lee, Sun Il; Kim, Moo Seong

Abstract

OBJECTIVE
The present study is conducted to evaluate the overally surgical results in 2,178 patients with intracranial aneurysms operated in our institution from January 1980 to December 30th, 2000.
METHODS
The anterior communicating artery aneurysms was 720 case, internal carotid artery aneurysms 576, middle cerebral artery aneurysms 588, anterior cerebral artery aneurysms 57 and vertebro-basilar artery aneuryms was 78 case. The male to female ratio was 0.7 to 1. Surgical methods were 1,968 clippings, 170 coatings and wrappings, 22 aneurysmorraphy, 18 proximal ligations.
RESULTS
Incidence of the rebleeding was 5.6% of the early operation group, 17% of the late operation group. Incidence of the clinical vasospasm was 18.6%, angiographic vasospasm was 26.2%. The multiple aneurysms was 8.6%, dissecting aneurysm 4 cases(0.2%), "De Novo" aneurysm 4 cases(0.19%), lobectomy cases 7 cases(0.32%), and incidental aneurysms 108 cases(5.01%) respectively. Overall surgical result was favorble outcome in 86% and mortality in 7%. In early surgery group, favorable outcome was 88%, mortality was 6%. The calcium-channel blocker and "Triple-H" therapy improved the post-operative morbidity significantly. In old age group, favorable outcome was 85.5% and 8.5% mortality rate in early operation group, favorable outcome 69.8%, mortality 11.3% in late operation group. Intraoperative angiography reduced residual aneurysm or remained aneurysm in large, giant aneurysm, and complicated aneurysm especially in anterior communication artery aneurysm.
CONCLUSION
It is important to know our own statisticts about the cerebrovascular disease in Korea. We present the large series of aneurysm surgery in one institute.