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Gaberel T. Open vascular neurosurgery is not dead! Long live open vascular neurosurgery! Neurochirurgie 2023; 69:101454. [PMID: 37271054 DOI: 10.1016/j.neuchi.2023.101454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Thomas Gaberel
- Department of Neurosurgery, University Hospital of Caen, 14000 Caen, France; Normandie University, UNICAEN, Inserm, U1237, Physiopathology and Imaging of Neurological Disorders (PhIND), Institut Blood and Brain at Caen-Normandie, Cyceron, 14000 Caen, France.
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Metayer T, Lechanoine F, Bougaci N, de Schlichting E, Terrier L, Derrey S, Barbier C, Papagiannaki C, Ashraf A, Tahon F, Leplus A, Gay E, Emery E, Briant AR, Vivien D, Gaberel T. Retreatment of previously treated intracranial aneurysm: Procedural complications and risk factors for complications. Neurochirurgie 2021; 68:150-155. [PMID: 34487752 DOI: 10.1016/j.neuchi.2021.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 08/23/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Intracranial aneurysm (IA) is a frequent vascular malformation that can be managed by endovascular treatment (EVT) or microsurgery. A previously treated IA can recanalize, which may require further treatment. The aim of our study was to evaluate procedural complications related to IA retreatment and their risk factors. METHODS All patients retreated for IA between 2007 and 2017 in 4 hospitals were included. We retrospectively reviewed the frequency of procedural complications of IA retreatment, defined as death or≥1-point increase in modified Rankin score 24h after the procedure. We then screened for risk factors of procedural complications by comparing the characteristics of patients with and without complications. RESULTS During the inclusion period, 4,997 IAs were treated in our 4 institutions. Of these, 237 (4.7%) were retreated. 29 (12.2%) had≥1 procedural complication. However, severe complications, defined as death or dependency at 1 month, occurred only in 3 patients (1.3%). The only risk factor for complications was microsurgical clipping as retreatment. CONCLUSIONS Procedural complications during IA retreatment were frequent but, in most cases, retreatment did not lead to death or severe disability. The only risk factor for complications of IA retreatment was clipping as retreatment. However, the design of the study did not allow any conclusion to be drawn as to the optimal means of aneurysm retreatment, and further studies are needed.
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Affiliation(s)
- T Metayer
- Department of Neurosurgery, University Hospital of Caen, Avenue de la Côte de Nacre, 14000 Caen, France; Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, 14000 Caen, France.
| | - F Lechanoine
- Department of Neurosurgery, University Hospital of Grenoble, 38000 Grenoble, France
| | - N Bougaci
- Department of Neurosurgery, University Hospital of Nice, 06000 Nice, France
| | - E de Schlichting
- Department of Neurosurgery, University Hospital of Grenoble, 38000 Grenoble, France
| | - L Terrier
- Department of Neurosurgery, University Hospital of Rouen, 76000 Rouen, France
| | - S Derrey
- Department of Neurosurgery, University Hospital of Nice, 06000 Nice, France
| | - C Barbier
- Department of Neurosurgery, University Hospital of Rouen, 76000 Rouen, France; Department of Biostatistics, University Hospital of Caen, Caen, France
| | - C Papagiannaki
- Department of Neuroradiology, University Hospital of Caen, 14000 Caen, France
| | - A Ashraf
- Department of Neurosurgery, University Hospital of Grenoble, 38000 Grenoble, France
| | - F Tahon
- Department of Neuroradiology, University Hospital of Rouen, 76000 Rouen, France
| | - A Leplus
- Department of Neurosurgery, University Hospital of Nice, 06000 Nice, France
| | - E Gay
- Department of Neurosurgery, University Hospital of Grenoble, 38000 Grenoble, France
| | - E Emery
- Department of Neurosurgery, University Hospital of Caen, Avenue de la Côte de Nacre, 14000 Caen, France; Department of Neuroradiology, University Hospital of Grenoble, 38000 Grenoble, France
| | - A R Briant
- Medical School, University of Caen Normandy, 14000 Caen, France; Department of Biostatistics, University Hospital of Caen, Caen, France
| | - D Vivien
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, 14000 Caen, France; Department of Neuroradiology, University Hospital of Grenoble, 38000 Grenoble, France
| | - T Gaberel
- Department of Neurosurgery, University Hospital of Caen, Avenue de la Côte de Nacre, 14000 Caen, France; Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, 14000 Caen, France.
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