title: Assessment of long-term results of intracranial aneurysm clipping by means of computed tomography angiography.
abstract: OBJECTIVE
  The aim of this retrospective study was to assess the effectiveness of aneurysm clipping by computed tomography angiography (CTA) in a long-term follow-up.
  
  
  METHODS
  The CTA examination was performed in 119 patients who had 143 aneurysms clipped. The examinations were performed 3 to 11 years (mean 6 years) after clipping using a GE Lightspeed PRO16 scanner.
  
  
  RESULTS
  In all cases but one, good quality CTA images, suitable for evaluation of the arteries around the clip site, were obtained. Complete aneurysm closure without neck remnant or regrowth was confirmed in 137 (96%) aneurysms. In 4 (3%) cases, neck remnants were detected (2 on the anterior communicating artery [AComA] and 2 on the middle cerebral artery [MCA]). A total clip slippage from the aneurysm dome was revealed in 1 case. One case of aneurysm re-rupture was noted, 11 years after clipping. The rebleeding was caused by AComA aneurysm regrowth. Among these 6 patients with unsatisfactory clipping, 2 required further treatment and 4 remain under observation. Nineteen 'de novo' aneurysms in other locations were found in 14 (12%) patients. Summing up all of the pathological findings in the study group, there were 18 (15%) patients who needed further management including close surveillance or re-treatment.
  
  
  CONCLUSIONS
  Computed tomography angiography is a simple and reliable method of aneurysm clipping evaluation. The long- term follow-up CTA confirmed the permanent and complete obliteration of 96% of the aneurysms. The rate of unsatisfactory aneurysm closure was 4%, but only 1.4% needed re-treatment during a mean follow-up of 6 years. The annual risk of aneurysm re-rupture was 0.1%.
authors.affiliation: Katedra i Klinika Neurochirurgii, Warszawski Uniwersytet Medyczny, Warszawa, Poland. pkunert@wp.pl
authors.forename: Przemysław
authors.initials: P
authors.lastname: Kunert
authors.forename: Marek
authors.initials: M
authors.lastname: Prokopienko
authors.forename: Magdalena
authors.initials: M
authors.lastname: Gola
authors.forename: Tomasz
authors.initials: T
authors.lastname: Dziedzic
authors.forename: Maciej
authors.initials: M
authors.lastname: Jaworski
authors.forename: Andrzej
authors.initials: A
authors.lastname: Marchel
mesh_terms: D000328:Adult; D000368:Aged; D020771:Anterior Cerebral Artery / Q000000981:diagnostic imaging / Q000601:surgery; D002533:Cerebral Angiography / Q000379:methods*; D057510:Endovascular Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000601:surgery; D019635:Neurosurgical Procedures; D011182:Postoperative Care / Q000379:methods; D012189:Retrospective Studies; D013525:Surgical Instruments; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult