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Outcome After Surgical Treatment of Paraclinoid Carotid Aneurysms

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Trends in Cerebrovascular Surgery

Part of the book series: Acta Neurochirurgica Supplement ((NEUROCHIRURGICA,volume 123))

Abstract

Surgery on paraclinoid carotid aneurysms is technically demanding and entails considerable risks, especially to visual function. The aim of this study was to evaluate the clinical and visual outcome after surgery in 66 patients with paraclinoid carotid aneurysms (30 ruptured and 36 unruptured) treated between 1990 and 2014. Thirty-six aneurysms were of standard size, and 30 were large (16–20 mm) or giant (>20 mm); the Barami classification was used in every case. During surgery, multiple clips were needed in 25 % of patients with standard, and in 80 % of patients with large-giant aneurysms; temporary carotid occlusion was performed on 11 % of patients with standard and 63 % with large-giant aneurysms. Postoperatively, a cerebrospinal fluid fistula was repaired surgically in two patients. At the 3-month follow-up, the modified Rankin Score (mRS) was favorable (0–2) in 63 % of patients with ruptured and in 97 % with unruptured aneurysms; four patients presenting with large hematomas died. Postoperative visual impairment (worsening or newly developing deficit) was noted in 25 % of cases with standard and 14 % of cases with large-giant ruptured aneurysms, and, respectively, in 10 % with standard and 31 % with large-giant unruptured aneurysms. It has been concluded that surgery remains a reasonable choice in the management of patients with paraclinoid carotid aneurysms.

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Conflict of Interest

We confirm that we have no conflict of interest.

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Authors and Affiliations

  1. Section of Vascular Neurosurgery, Insitute of Neurosurgery, Azienda Ospedaliera – Universitaria Integrata di Verona, Piazzale Stefani, 1, Verona, 37100, Italy

    Alberto Pasqualin MD & Pietro Meneghelli MD

  2. Division of Neurosurgery, Cesena City Hospital, Cesena, Italy

    Francesco Cozzi MD

  3. Division of Neurosurgery, Trento City Hospital, Trento, Italy

    Franco Chioffi

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  1. Alberto Pasqualin MD
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  2. Pietro Meneghelli MD
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  3. Francesco Cozzi MD
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  4. Franco Chioffi
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Corresponding author

Correspondence to Alberto Pasqualin MD .

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Editors and Affiliations

  1. Kyoto Medical Center, National Hospital Organization, Fukakusa, Fushimi-ku, Kyoto, Japan

    Tetsuya Tsukahara

  2. Institute of Neurosurgery, Verona City Hospital, Verona, Italy

    Alberto Pasqualin

  3. Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland

    Giuseppe Esposito

  4. Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland

    Luca Regli

  5. Institute of Neurosurgery, Verona City Hospital, Verona, Italy

    Giampietro Pinna

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Pasqualin, A., Meneghelli, P., Cozzi, F., Chioffi, F. (2016). Outcome After Surgical Treatment of Paraclinoid Carotid Aneurysms. In: Tsukahara, T., Pasqualin, A., Esposito, G., Regli, L., Pinna, G. (eds) Trends in Cerebrovascular Surgery. Acta Neurochirurgica Supplement, vol 123. Springer, Cham. https://doi.org/10.1007/978-3-319-29887-0_5

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  • DOI: https://doi.org/10.1007/978-3-319-29887-0_5

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-29885-6

  • Online ISBN: 978-3-319-29887-0

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