脳卒中の外科
Online ISSN : 1880-4683
Print ISSN : 0914-5508
ISSN-L : 0914-5508
特集 未破裂脳動脈瘤治療の長期予後
外科治療後5年以上経過した未破裂脳動脈瘤の長期的転帰
小野 純一町田 利生永野 修藤川 厚青柳 京子足立 明彦野村 亮太樋口 佳則佐伯 直勝
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2012 年 40 巻 5 号 p. 310-316

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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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© 2012 一般社団法人 日本脳卒中の外科学会
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