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Vol. 40 (2012) No. 5 p. 310-316



特集 未破裂脳動脈瘤治療の長期予後

Long-term outcomes of the surgically treated unruptured intracranial aneurysms (UIA) are not well known. We conducted this study to clarify the surgical results and the long-term outcomes of the surgically treated UIA.
Seventy-three consecutive patients who were surgically treated and were followed over five years were enrolled in this study. Mean (median) age was 58.3 (59) years. The location of aneurysm was as follows: internal carotid in 32%, middle cerebral in 27%, multiple in 23% and so on. In the aneurysmal size, medium (4–11 mm) was most common (55%), followed by large or giant (12 mm or more) one (16%).
Results: 1) Permanent surgical morbidity was 5.5% and mortality was 1.4% (one case due to fulminant hepatitis). 2) Surgical treatment of the single aneurysm: craniotomy in 57 patients and intervention (GDC embolization) in four. 3) Mean (median) follow-up period was 8.6 (8) years. 4) Regrowth of the aneurysm was observed in one patient (1.4%), and de novo aneurysms were visualized in three (4.5%). 5) Long-term outcomes: modified Rankin scale 0–1 in 65 patients (89%), and six in five (7%). 6) Factors related to outcomes: cardiovascular events were seen in five patients; cerebrovascular in three patients and cardiac in two.
It is concluded that long-term outcomes of UIA were fairly favorable, and cardio- and cerebrovascular events were the main factor related to unfavorable outcome.

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