Outcome for middle cerebral artery aneurysm surgery.
OBJECTIVE
To assess in depth the variables contributing to adverse surgical outcome for repair of unruptured middle cerebral artery aneurysms.


METHODS
Prospectively collected data between October 1989 and June 2009 were examined retrospectively. Putative risk factors were investigated with univariate and multivariate logistic regression analyses.


RESULTS
In this study, 263 patients (339 aneurysms) underwent surgical clipping in 280 operations for unruptured middle cerebral artery aneurysms. The overall surgical mortality and morbidity rate was 5% (95% confidence interval [CI], 2.9-8.3). Multivariate logistic analysis of risk factors revealed that age and aneurysm size were independent predictors of surgical outcome. Patients < 60 years of age with an aneurysm < or = 12 mm constituted a low-risk group with a procedure-related combined mortality and morbidity of 0.6% (95% CI, 0-3.8). Patients < 60 years of age with an aneurysm > 12 mm had a procedure-related combined mortality and morbidity of 7.4% (95% CI, 1-24.5). Patients > or = 60 years of age with an aneurysm of < or = 12 mm had a procedure-related combined mortality and morbidity of 9.3% (95% CI, 4.3-18.3). Patients > or = 60 years of age with an aneurysm > 12 mm had a procedure-related combined mortality and morbidity of 22.2% (95% CI, 8.5-45.8).


CONCLUSIONS
Age and size of aneurysm were the only 2 independent predictors of surgical outcome.
Morgan
Michael K
MK
Australian School of Advanced Medicine, Level 1, 3 Dow Corning, Innovation Rd, Macquarie University, NSW 2109, Australia. michael.morgan@mq.edu.au
Mahattanakul
Wattana
W
Davidson
Andrew
A
Reid
John
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D018450:Disease Progression; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008866:Microsurgery / Q000379:methods* / Q000401:mortality; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods* / Q000401:mortality; D011859:Radiography; D012189:Retrospective Studies; D014656:Vascular Surgical Procedures / Q000379:methods* / Q000401:mortality; D055815:Young Adult