1227. Surgical Management of Paraclinoid Aneurysms in Solo Neurosurgical Practice

Authors: Hotetsu Shimamoto, MD; Hotetsu Shimamoto (Ohnogyo, Japan)

To analyze the results of surgical intervention for paraclinoid aneurysm of the past 14 years.

Between 2004 Jan. and 2018 May, we have treated 68 patients (7 males, mean age at surgery:  55.8 years, range:  30~83 years) who underwent surgical interventions for unruptured paraclinoid aneurysm. Their location numbers are as follow: dosal wall 21,medial wall 34, lateral wall 2 and ventral wall 11. Aneurysm location, size and postoperative results were investigated. Outcomes were assessed on the basis of a modified Rankin Scale (mRS).

The overall rate of mRS 0 was 63 cases (92.6%), mRS 1 was 2 cases (2.9%) with partial visual disturbance, mRS 2 was 2 cases (2.9%) with one blindness, one with rt.hemiweakness due to thromboembolism and mRS 4 was one (1.5%) with lt.hemiparesis due to medical comorbidity.

The direct clipping method utilizing advanced techniques is the preferred approach and continues to be a good option for the treatment of paraclinoid aneurysms.  Careful surgical consideration is necessary for elderly and mdical risk patients.