BACKGROUND

Treatment of cerebral aneurysms is followed by more favorable results in hospitals with at least 50—100 patients annually. In this regard, analysis and comparison of data from various clinics are of interest.

OBJECTIVE

To analyze the features of microsurgical treatment of cerebral aneurysms, immediate clinical and angiographic results.

MATERIAL AND METHODS

There were 600 patients with cerebral aneurysms aged 16—79 years (mean 53.7±12) between 01/09/2024 and 12/29/2024. There were multiple aneurysms in 29.7% of patients. Saccular and fusiform aneurysms were observed in 95% and 5% of patients. Giant aneurysms were detected in 1.8% of cases. Aneurysms of anterior and middle cerebral arteries accounted for 74.3%. Forty-nine (8.2%), 29 (4.8%) and 99 (16.5%) patients underwent surgery in acute (1—14 days), subacute (15—21 days) and delayed (>21 days) period of hemorrhage. Cerebral aneurysms with mass effect were noted in 8 patients (1.3%), ischemia — in 15 (2.5%) cases. Incidental aneurysms were diagnosed in 400 patients (66.7%).

RESULTS

Aneurysm neck clipping was performed in 97.5% of cases, trapping without anastomosis — 0.6%, trapping with anastomosis — 1.2%, reinforcement of microaneurysms with autologous muscle — in 0.7% of cases. There was mRS score 0—2 after 14 postoperative days in 96.3% of patients. Postoperative complications were noted in 14% of cases. There were no fatal cases. Complete exclusion of saccular aneurysms was achieved in 92.2% of cases, fusiform aneurysms — in 69.5% of cases.

CONCLUSION

Microsurgical treatment of patients with cerebral aneurysms in high-flow hospitals demonstrates favorable clinical and angiographic results. Favorable postoperative results require modern methods of preoperative diagnostics, accumulation of experience by neurosurgeons, adherence to algorithms for choosing a treatment method and current intensive care protocols, as well as preparation for surgery taking into account surgical risks associated with concomitant diseases.