1227. Surgical Management of Paraclinoid Aneurysms in Solo Neurosurgical Practice

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

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

Methods:
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).

Results:
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.

Conclusion:
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.