Dokument: The morphological, clinical, and prognostic factors in the management of giant anterior communicating artery aneurysms: A systematic review of cases

Titel:The morphological, clinical, and prognostic factors in the management of giant anterior communicating artery aneurysms: A systematic review of cases
URL für Lesezeichen:https://docserv.uni-duesseldorf.de/servlets/DocumentServlet?id=68771
URN (NBN):urn:nbn:de:hbz:061-20250224-094152-2
Kollektion:Publikationen
Sprache:Englisch
Dokumententyp:Wissenschaftliche Texte » Artikel, Aufsatz
Medientyp:Text
Autoren: Nasir, Roua [Autor]
Naqvi, Midhat [Autor]
Naqvi, Zahra [Autor]
Ahmed, Salaar [Autor]
Hassan, Maarij ul [Autor]
Tariq, Rabeet [Autor]
Khan, Saad Akhter [Autor]
Koeskemeier, Pia [Autor]
Khajuria, Rajiv Kumar [Autor]
Bajwa, Mohammad Hamza [Autor]
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Dateien vom 24.02.2025 / geändert 24.02.2025
Stichwörter:Giant intracranial aneurysm, Endovascular, Anterior communicating artery, Direct clipping, Cerebrovascular surgery, Bypass
Beschreibung:Introduction
Giant intracranial aneurysms (GIAs) of the anterior communicating artery (AComm) are rare and challenging to treat due to their distinct angioarchitecture.
Research question
To review demographic, morphological, clinical, and prognostic factors in the treatment of giant AComm aneurysms to inform decision-making.
Materials and methods
Medline, Scopus, and Cochrane databases were searched for records examining cases diagnosed with giant AComm aneurysms. The study type, sample size, patient age, aneurysm site, aneurysm size, presenting complaints, and treatment modality were tabulated, and methodological quality was assessed. Additionally, two cases from our institution were included.
Results
The data from 24 retrieved records, including 45 cases (60% treated with direct clipping/clip reconstruction, 20% with surgical bypass±trapping, and 16% with endovascular/combined methods) were obtained. The mean age was 52 years with an overall male preponderance (3:1). 73% presented with symptoms; mostly visual impairment/loss and subarachnoid hemorrhage. 82% had favorable outcomes (mRS 0–2). 56% had a mean maximum diameter between 25 and 30 mm. Cases treated by direct clipping/reconstruction were primarily ruptured, while cases treated by surgical bypass/trapping were unruptured or asymptomatic. Endovascular/combined methods were utilized for only few cases.
Discussion and conclusion
Immediate suspicion is warranted for visual impairment with headaches in adults or seizures in the elderly. Direct clipping is the first-line treatment for ruptured cases closely followed by surgical bypass and trapping for unruptured cases. There is limited data on endovascular/combined methods. Evidence from case reports/series should be interpreted with caution. Both inter-modality and intra-modality nuances exist.
Rechtliche Vermerke:Originalveröffentlichung:
Nasir, R., Naqvi, M. e Z., Ahmed, S., Hassan, M. ul, Tariq, R., Khan, S. A., Köskemeier, P., Khajuria, R. K., Bajwa, M. H., & Muhammad, S. (2025). The morphological, clinical, and prognostic factors in the management of giant anterior communicating artery aneurysms: A systematic review of cases. Brain and Spine, 5, Article 104189. https://doi.org/10.1016/j.bas.2025.104189
Lizenz:Creative Commons Lizenzvertrag
Dieses Werk ist lizenziert unter einer Creative Commons Namensnennung 4.0 International Lizenz
Fachbereich / Einrichtung:Medizinische Fakultät
Dokument erstellt am:24.02.2025
Dateien geändert am:24.02.2025
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