title: Clinical Risk Factors Affecting Procedure-Related Major Neurological Complications in Unruptured Intracranial Aneurysms.
abstract: OBJECTIVE
  The operative risk and natural history rupture risk for the treatment of unruptured intracranial aneurysms (UIAs) should be evaluated. The purpose of this study was to report our experience with treating UIAs and to outline clinical risk factors associated with procedure-related major neurological complications.
  
  
  METHODS
  We treated 1158 UIAs in 998 patients over the last 14 years. All patients underwent operation performed by a single microvascular surgeon and two interventionists at a single institution. Patient factors, aneurysm factors, and clinical outcomes were analyzed in relation to procedure-related complications.
  
  
  RESULTS
  The total complication rate was 22 (2.2%) out of 998 patients. Among them, complications developed in 14 (2.3%) out of 612 patients who underwent microsurgery and in 8 (2.1%) out of 386 patients who underwent endovascular procedures. One patient died due to intraoperative rupture during an endovascular procedure. The procedure-related complication was highly correlated with age (p=0.004), hypertension (p=0.002), and history of ischemic stroke (p<0.001) in univariate analysis. The multivariate analysis revealed previous history of ischemic stroke (p=0.001) to be strongly correlated with procedure-related complications.
  
  
  CONCLUSIONS
  A history of ischemic stroke was strongly correlated with procedure-related major neurological complications when treating UIAs. Accordingly, patients with UIAs who have a previous history of ischemic stroke might be at risk of procedure-related major neurological complications.
authors.affiliation: Department of Neurosurgery, Cerebrovascular Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: E-Wook
authors.initials: EW
authors.lastname: Jang
authors.affiliation: Department of Neurosurgery, Cerebrovascular Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Yong Bae
authors.initials: YB
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Cerebrovascular Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.; Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Joonho
authors.initials: J
authors.lastname: Chung
authors.affiliation: Department of Radiology, Cerebrovascular Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Sang Hyun
authors.initials: SH
authors.lastname: Suh
authors.affiliation: Department of Neurosurgery, Cerebrovascular Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.; Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Chang-Ki
authors.initials: CK
authors.lastname: Hong
authors.affiliation: Department of Neurosurgery, Cerebrovascular Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. jyjoo@yuhs.ac.
authors.forename: Jin-Yang
authors.initials: JY
authors.lastname: Joo
mesh_terms: D000368:Aged; D017542:Aneurysm, Ruptured; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000453:epidemiology / Q000601:surgery*; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D009422:Nervous System Diseases; D019635:Neurosurgical Procedures; D011183:Postoperative Complications / Q000453:epidemiology*; D012306:Risk; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Unruptured intracranial aneurysm; complication; ischemic stroke; procedure