Open Microsurgical Cerebral Aneurysm Treatment After Failed
Endovascular Therapy: An Evaluation of Aneurysm Treatment
Frequencies in All Neurovascular Centers Across Austria and the
Czech Republic Over 20 Years

J 2024

Open Microsurgical Cerebral Aneurysm Treatment After Failed Endovascular Therapy: An Evaluation of Aneurysm Treatment Frequencies in All Neurovascular Centers Across Austria and the Czech Republic Over 20 Years

GRIESSENAUER, Christoph J; Philippe DODIER; Nico H STROH; Petra A MERCEA; Gerhard BAVINZSKI et al.

Základní údaje

Originální název

Open Microsurgical Cerebral Aneurysm Treatment After Failed Endovascular Therapy: An Evaluation of Aneurysm Treatment Frequencies in All Neurovascular Centers Across Austria and the Czech Republic Over 20 Years

Autoři

Vydání

Neurosurgery, PHILADELPHIA, LIPPINCOTT WILLIAMS & WILKINS, 2024, 0148-396X

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30212 Surgery

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 3.900

Označené pro přenos do RIV

Ano

Kód RIV

RIV/00216224:14110/24:00138517

Organizační jednotka

Lékařská fakulta

Klíčová slova anglicky

Epidemiology; Failed endovascular therapy; Open microvascular surgery; Ruptured aneurysms; Unruptered aneuryms

Štítky

14110224, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 17. 1. 2025 10:34, Mgr. Tereza Miškechová

Anotace

V originále

BACKGROUND AND OBJECTIVES:Endovascular treatment of cerebral aneurysms has tremendously advanced over the past decades. Nevertheless, aneurysm residual and recurrence remain challenges after embolization. The objective of this study was to elucidate the portion of embolized aneurysms requiring open surgery and evaluate whether newer endovascular treatments have changed the need for open surgery after failed embolization.METHODS:All 15 cerebrovascular centers in Austria and the Czech Republic provided overall aneurysm treatment frequency data and retrospectively reviewed consecutive cerebral aneurysms treated with open surgical treatment after failure of embolization from 2000 to 2022. All endovascular modalities were included.RESULTS:On average, 1362 aneurysms were treated annually in the 2 countries. The incidence increased from 0.006% in 2005 to 0.008% in 2020 in the overall population. Open surgery after failed endovascular intervention was necessary in 128 aneurysms (0.8%), a proportion that remained constant over time. Subarachnoid hemorrhage was the initial presentation in 70.3% of aneurysms. The most common location was the anterior communicating artery region (40.6%), followed by the middle cerebral artery (25.0%). The median diameter was 6 mm (2-32). Initial endovascular treatment included coiling (107 aneurysms), balloon-assist (10), stent-assist (4), intrasaccular device (3), flow diversion (2), and others (2). Complete occlusion after initial embolization was recorded in 40.6%. Seventy-one percent of aneurysms were operated within 3 years after embolization. In 7%, the indication for surgery was (re-)rupture and, in 88.3%, reperfusion. Device removal was performed in 16.4%. Symptomatic intraoperative and postoperative complications occurred in 10.2%. Complete aneurysm occlusion after open surgery was achieved in 94%.CONCLUSION:Open surgery remains a rare indication for cerebral aneurysms after failed endovascular embolization even in the age of novel endovascular technology, such as flow diverters and intrasaccular devices. Regardless, it is mostly performed for ruptured aneurysms initially treated with primary coiling that are in the anterior circulation.

Citovat

GRIESSENAUER, Christoph J; Philippe DODIER; Nico H STROH; Petra A MERCEA; Gerhard BAVINZSKI; Christian DORFER; Karl ROESSLER; Andreas GRUBER; Matthias GMEINER; Claudius THOME; Klaus A LEBER; Stefan WOLFSBERGER; Mustafa BAGHBAN; Rahman AL-SCHAMERI; Michael KRAL; Som THAKUR; Manuel LUNZER; Branko POPADIC; Camillo SHERIF; Vilém JURÁŇ; Martin SMRČKA; David NETUKA; Anna STEKLACOVA; Radim LIPINA; Tomas HRBAC; Zdenek VECERA; Jiri FIEDLER; Marek GRUBHOFFER; Lumir HRABALEK; David KRAHULIK; Lukas KOLLER; Thomas KRETSCHMER; Vladimir PRIBAN; Jan MRACEK; Martin SAMES; Ales HEJCL; Jan KLENER; Jan SROUBEK a Petr ONDRA. Open Microsurgical Cerebral Aneurysm Treatment After Failed Endovascular Therapy: An Evaluation of Aneurysm Treatment Frequencies in All Neurovascular Centers Across Austria and the Czech Republic Over 20 Years. Neurosurgery. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS, 2024, roč. 95, č. 6, s. 1349-1357. ISSN 0148-396X. Dostupné z: https://doi.org/10.1227/neu.0000000000003040.

@article{2468679,
   author = {Griessenauer, Christoph J and Dodier, Philippe and Stroh, Nico H and Mercea, Petra A and Bavinzski, Gerhard and Dorfer, Christian and Roessler, Karl and Gruber, Andreas and Gmeiner, Matthias and Thome, Claudius and Leber, Klaus A and Wolfsberger, Stefan and Baghban, Mustafa and AlandSchameri, Rahman and Kral, Michael and Thakur, Som and Lunzer, Manuel and Popadic, Branko and Sherif, Camillo and Juráň, Vilém and Smrčka, Martin and Netuka, David and Steklacova, Anna and Lipina, Radim and Hrbac, Tomas and Vecera, Zdenek and Fiedler, Jiri and Grubhoffer, Marek and Hrabalek, Lumir and Krahulik, David and Koller, Lukas and Kretschmer, Thomas and Priban, Vladimir and Mracek, Jan and Sames, Martin and Hejcl, Ales and Klener, Jan and Sroubek, Jan and Ondra, Petr},
   article_location = {PHILADELPHIA},
   article_number = {6},
   doi = {https://doi.org/10.1227/neu.0000000000003040},
   keywords = {Epidemiology; Failed endovascular therapy; Open microvascular surgery; Ruptured aneurysms; Unruptered aneuryms},
   language = {eng},
   issn = {0148-396X},
   journal = {Neurosurgery},
   title = {Open Microsurgical Cerebral Aneurysm Treatment After Failed Endovascular Therapy: An Evaluation of Aneurysm Treatment Frequencies in All Neurovascular Centers Across Austria and the Czech Republic Over 20 Years},
   url = {https://journals.lww.com/neurosurgery/fulltext/2024/12000/open_microsurgical_cerebral_aneurysm_treatment.14.aspx},
   volume = {95},
   year = {2024}
}

TY  - JOUR
ID  - 2468679
AU  - Griessenauer, Christoph J - Dodier, Philippe - Stroh, Nico H - Mercea, Petra A - Bavinzski, Gerhard - Dorfer, Christian - Roessler, Karl - Gruber, Andreas - Gmeiner, Matthias - Thome, Claudius - Leber, Klaus A - Wolfsberger, Stefan - Baghban, Mustafa - Al-Schameri, Rahman - Kral, Michael - Thakur, Som - Lunzer, Manuel - Popadic, Branko - Sherif, Camillo - Juráň, Vilém - Smrčka, Martin - Netuka, David - Steklacova, Anna - Lipina, Radim - Hrbac, Tomas - Vecera, Zdenek - Fiedler, Jiri - Grubhoffer, Marek - Hrabalek, Lumir - Krahulik, David - Koller, Lukas - Kretschmer, Thomas - Priban, Vladimir - Mracek, Jan - Sames, Martin - Hejcl, Ales - Klener, Jan - Sroubek, Jan - Ondra, Petr
PY  - 2024
TI  - Open Microsurgical Cerebral Aneurysm Treatment After Failed Endovascular Therapy: An Evaluation of Aneurysm Treatment Frequencies in All Neurovascular Centers Across Austria and the Czech Republic Over 20 Years
JF  - Neurosurgery
VL  - 95
IS  - 6
SP  - 1349-1357
EP  - 1349-1357
PB  - LIPPINCOTT WILLIAMS & WILKINS
SN  - 0148396X
KW  - Epidemiology
KW  - Failed endovascular therapy
KW  - Open microvascular surgery
KW  - Ruptured aneurysms
KW  - Unruptered aneuryms
UR  - https://journals.lww.com/neurosurgery/fulltext/2024/12000/open_microsurgical_cerebral_aneurysm_treatment.14.aspx
N2  - BACKGROUND AND OBJECTIVES:Endovascular treatment of cerebral aneurysms has tremendously advanced over the past decades. Nevertheless, aneurysm residual and recurrence remain challenges after embolization. The objective of this study was to elucidate the portion of embolized aneurysms requiring open surgery and evaluate whether newer endovascular treatments have changed the need for open surgery after failed embolization.METHODS:All 15 cerebrovascular centers in Austria and the Czech Republic provided overall aneurysm treatment frequency data and retrospectively reviewed consecutive cerebral aneurysms treated with open surgical treatment after failure of embolization from 2000 to 2022. All endovascular modalities were included.RESULTS:On average, 1362 aneurysms were treated annually in the 2 countries. The incidence increased from 0.006% in 2005 to 0.008% in 2020 in the overall population. Open surgery after failed endovascular intervention was necessary in 128 aneurysms (0.8%), a proportion that remained constant over time. Subarachnoid hemorrhage was the initial presentation in 70.3% of aneurysms. The most common location was the anterior communicating artery region (40.6%), followed by the middle cerebral artery (25.0%). The median diameter was 6 mm (2-32). Initial endovascular treatment included coiling (107 aneurysms), balloon-assist (10), stent-assist (4), intrasaccular device (3), flow diversion (2), and others (2). Complete occlusion after initial embolization was recorded in 40.6%. Seventy-one percent of aneurysms were operated within 3 years after embolization. In 7%, the indication for surgery was (re-)rupture and, in 88.3%, reperfusion. Device removal was performed in 16.4%. Symptomatic intraoperative and postoperative complications occurred in 10.2%. Complete aneurysm occlusion after open surgery was achieved in 94%.CONCLUSION:Open surgery remains a rare indication for cerebral aneurysms after failed endovascular embolization even in the age of novel endovascular technology, such as flow diverters and intrasaccular devices. Regardless, it is mostly performed for ruptured aneurysms initially treated with primary coiling that are in the anterior circulation.
ER  -

GRIESSENAUER, Christoph J; Philippe DODIER; Nico H STROH; Petra A MERCEA; Gerhard BAVINZSKI; Christian DORFER; Karl ROESSLER; Andreas GRUBER; Matthias GMEINER; Claudius THOME; Klaus A LEBER; Stefan WOLFSBERGER; Mustafa BAGHBAN; Rahman AL-SCHAMERI; Michael KRAL; Som THAKUR; Manuel LUNZER; Branko POPADIC; Camillo SHERIF; Vilém JURÁŇ; Martin SMRČKA; David NETUKA; Anna STEKLACOVA; Radim LIPINA; Tomas HRBAC; Zdenek VECERA; Jiri FIEDLER; Marek GRUBHOFFER; Lumir HRABALEK; David KRAHULIK; Lukas KOLLER; Thomas KRETSCHMER; Vladimir PRIBAN; Jan MRACEK; Martin SAMES; Ales HEJCL; Jan KLENER; Jan SROUBEK a Petr ONDRA. Open Microsurgical Cerebral Aneurysm Treatment After Failed Endovascular Therapy: An Evaluation of Aneurysm Treatment Frequencies in All Neurovascular Centers Across Austria and the Czech Republic Over 20 Years. \textit{Neurosurgery}. PHILADELPHIA: LIPPINCOTT WILLIAMS \&{} WILKINS, 2024, roč.~95, č.~6, s.~1349-1357. ISSN~0148-396X. Dostupné z: https://doi.org/10.1227/neu.0000000000003040.

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