COMPARISON OF MORTALITY AND POSTOPERATIVE COMPLICATIONS IN PATIENTS WITH CLIPPED RUPTURED VS. UNRUPTURED INTRACRANIAL ANEURYSMS

Authors

DOI:

https://doi.org/10.31435/ijitss.1(49).2026.4810

Keywords:

Intracranial Aneurysm, Aneurysm Clipping, Postoperative Complications Ruptured Aneurysm

Abstract

Introduction: Intracranial aneurysm (IA) is a weakening of a cerebral vessel that can lead to rupture and subarachnoid hemorrhage (SAH). Ruptured IAs account for about 85% of SAH cases, with high complication risks. Unruptured intracranial aneurysms (UIAs) are increasingly diagnosed due to advanced imaging techniques, with treatment options including clipping or coiling. The aim of the study was to compare mortality and the incidence of complications in patients after intracranial aneurysm clipping, with a distinction between previously ruptured and unruptured aneurysms.

Materials and methods: This retrospective study analyzed patients who underwent cerebral aneurysm clipping between 2022 and 2025 at the Clinical Department of Neurosurgery of the University Clinical Center named after Prof. K. Gibiński, Medical University of Silesia in Katowice, Poland. Data on sex, age, aneurysm location, status (ruptured/unruptured), and complications were collected. Statistical analysis used chi-square and Fisher's exact tests (p < 0,05).

Results: The study included 61 patients, with 46 females (75,41%) and 15 males (24,59%). Of the aneurysms, 46 (75,41%) were unruptured and 15 (24,59%) ruptured. Postoperative complications occurred in 21 patients (34,43%), including transient paresis, aphasia, and stroke. Three patients (4,92%) died. Chi-square and Fisher's tests showed no statistically significant differences in complications (p = 0,08) and mortality (p = 0,15) between ruptured and unruptured groups.

Conclusions: Postoperative complications were more common in ruptured aneurysms, though no statistical significance was found. The overall mortality rate was low, and no significant difference in mortality was observed between ruptured and unruptured aneurysms.

References

Zhu, W., Ling, X., Petersen, J. D., Liu, J., Xiao, A., & Huang, J. (2022). Clipping versus coiling for aneurysmal subarachnoid hemorrhage: A systematic review and meta-analysis of prospective studies. Neurosurgical Review, 45(2), 1291–1302. https://doi.org/10.1007/s10143-021-01704-0

Shen, Z., Zhao, Y., Gu, X., Fang, J., Yang, J., Li, T., & Fan, B. (2024). Systematic review of treatment for unruptured intracranial aneurysms: Clipping versus coiling. Turkish Neurosurgery, 34(3), 377–387. https://doi.org/10.5137/1019-5149.JTN.23729-18.1

Vlak, M. H., Algra, A., Brandenburg, R., & Rinkel, G. J. (2011). Prevalence of unruptured intracranial aneurysms, with emphasis on sex, age, comorbidity, country, and time period: A systematic review and meta-analysis. The Lancet Neurology, 10(7), 626–636. https://doi.org/10.1016/S1474-4422(11)70109-0

Zhang, Z., Liu, J. Y., Xing, H. S., Ma, J. Y., & Li, A. J. (2023). Microsurgical clipping and endovascular intervention for middle cerebral artery aneurysm: A meta-analysis. Medicine, 102(34), e34956. https://doi.org/10.1097/MD.0000000000034956

Yong-Wei, H., Wang, X. Y., Li, Z. P., & Yin, X. S. (2023). The rupture risk factors of mirror intracranial aneurysms: A systematic review and meta-analysis based on morphological and hemodynamic parameters. PLoS ONE, 18(6), e0286249. https://doi.org/10.1371/journal.pone.0286249

Yuan, J., Li, Z., Jiang, X., Lai, N., Wang, X., Zhao, X., Wu, D., Liu, J., Xia, D., Huang, C., & Fang, X. (2020). Hemodynamic and morphological differences between unruptured carotid–posterior communicating artery bifurcation aneurysms and infundibular dilations of the posterior communicating artery. Frontiers in Neurology, 11, 741. https://doi.org/10.3389/fneur.2020.00741

Xiang, J., Natarajan, S. K., Tremmel, M., Ma, D., Mocco, J., Hopkins, L. N., Siddiqui, A. H., Levy, E. I., & Meng, H. (2011). Hemodynamic-morphologic discriminants for intracranial aneurysm rupture. Stroke, 42(1), 144–152. https://doi.org/10.1161/STROKEAHA.110.592923

Yuan, J., Huang, C., Lai, N., Li, Z., Jiang, X., Wang, X., Zhao, X., Wu, D., Liu, J., Xia, D., & Fang, X. (2020). Hemodynamic and morphological analysis of mirror aneurysms prior to rupture. Neuropsychiatric Disease and Treatment, 16, 1339–1347. https://doi.org/10.2147/NDT.S254124

Li, L. R., You, C., & Chaudhary, B. (2016). Intraoperative mild hypothermia for postoperative neurological deficits in people with intracranial aneurysm. Cochrane Database of Systematic Reviews, 2016(3), CD008445. https://doi.org/10.1002/14651858.CD008445.pub3

Martinez-Perez, R., Hardesty, D. A., Silveira-Bertazzo, G., Albonette-Felicio, T., Carrau, R. L., & Prevedello, D. M. (2021). Safety and effectiveness of endoscopic endonasal intracranial aneurysm clipping: A systematic review. Neurosurgical Review, 44(2), 889–896. https://doi.org/10.1007/s10143-020-01316-0

Catapano, J. S., Nguyen, C. L., Frisoli, F. A., Sagar, S., Baranoski, J. F., Cole, T. S., Labib, M. A., Whiting, A. C., Ducruet, A. F., Albuquerque, F. C., & Lawton, M. T. (2021). Small intracranial aneurysms in the Barrow Ruptured Aneurysm Trial (BRAT). Acta Neurochirurgica, 163(1), 123–129. https://doi.org/10.1007/s00701-020-04602-4

Jabbarli, R., Wrede, K. H., Pierscianek, D., Dammann, P., El Hindy, N., Özkan, N., Müller, O., Stolke, D., Forsting, M., & Sure, U. (2016). Outcome after clipping of unruptured intracranial aneurysms depends on caseload. World Neurosurgery, 89, 666–671.e1. https://doi.org/10.1016/j.wneu.2015.12.043

Fuentes, A. M., Stone McGuire, L., & Amin-Hanjani, S. (2022). Sex differences in cerebral aneurysms and subarachnoid hemorrhage. Stroke, 53(2), 624–633. https://doi.org/10.1161/STROKEAHA.121.037147

Cras, T. Y., Bos, D., Ikram, M. A., Vergouwen, M. D. I., Dippel, D. W. J., Voortman, T., Adams, H. H. H., Vernooij, M. W., & Roozenbeek, B. (2020). Determinants of the presence and size of intracranial aneurysms in the general population: The Rotterdam Study. Stroke, 51(7), 2103–2110. https://doi.org/10.1161/STROKEAHA.120.029296

Burlakoti, A., Kumaratilake, J., Taylor, J., & Henneberg, M. (2024). Trend of cerebral aneurysms over the past two centuries: Need for early screening. BMJ Open, 14(2), e081290. https://doi.org/10.1136/bmjopen-2023-081290

Brinjikji, W., Zhu, Y. Q., Lanzino, G., Cloft, H. J., Murad, M. H., Wang, Z., & Kallmes, D. F. (2016). Risk factors for growth of intracranial aneurysms: A systematic review and meta-analysis. American Journal of Neuroradiology, 37(4), 615–620. https://doi.org/10.3174/ajnr.A4575

Keedy, A. (2006). An overview of intracranial aneurysms. McGill Journal of Medicine, 9(2), 141–146.

Sturiale, C. L., Scerrati, A., Ricciardi, L., Rustemi, O., Auricchio, A. M., Norri, N., Piazza, A., Ranieri, F., Tomatis, A., Albanese, A., Di Egidio, V., Farneti, M., Mangiola, A., Marchese, E., Raco, A., Volpin, L., & Trevisi, G. (2022). Clipping versus coiling for treatment of middle cerebral artery aneurysms: A retrospective Italian multicenter experience. Neurosurgical Review, 45(5), 3179–3191. https://doi.org/10.1007/s10143-022-01822-3

Zuurbier, C. C. M., Molenberg, R., Mensing, L. A., Wermer, M. J. H., Juvela, S., Lindgren, A. E., Jääskeläinen, J. E., Koivisto, T., Yamazaki, T., Uyttenboogaart, M., van Dijk, J. M. C., Aalbers, M. W., Morita, A., Tominari, S., Arai, H., Nozaki, K., Murayama, Y., Ishibashi, T., Takao, H., Gondar, R., Bijlenga, P., Rinkel, G. J. E., Greving, J. P., & Ruigrok, Y. M. (2022). Sex difference and rupture rate of intracranial aneurysms: An individual patient data meta-analysis. Stroke, 53(2), 362–369. https://doi.org/10.1161/STROKEAHA.121.035187

Swiatek, V. M., Amini, A., Marinescu, M., Dumitru, C. A., Spitz, L., Stein, K. P., Saalfeld, S., Rashidi, A., Sandalcioglu, I. E., & Neyazi, B. (2024). Sex differences in intracranial aneurysms: A matched cohort study. Journal of Personalized Medicine, 14(10), 1038. https://doi.org/10.3390/jpm14101038

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Published

2026-03-16

How to Cite

COMPARISON OF MORTALITY AND POSTOPERATIVE COMPLICATIONS IN PATIENTS WITH CLIPPED RUPTURED VS. UNRUPTURED INTRACRANIAL ANEURYSMS. (2026). International Journal of Innovative Technologies in Social Science, 2(1(49). https://doi.org/10.31435/ijitss.1(49).2026.4810