Intraoperative complications in aneurysm surgery: a prospective national study.

摘要: Object. With increasing use of endovascular procedures, the number aneurysms treated surgically will decline. in this study authors review complications related to surgical treatment and address issue maintaining quality standards on a national level. Methods. A prospective, nonselected amalgamation every aneurysm case five six neurosurgical centers Sweden during 1 calendar year was undertaken (422 patients; 7.4 persons/100,000 population/year). The protocols at these institutions were very similar. Outcome assessed using clinical end points. In series, 84.1% patients underwent surgery, intraoperative occurred 30% procedures. Poor outcome from technical seen 7.9% patients. Intraoperative rupture accounted for 60% branch sacrifice 12% all difficulties. Although significantly base geometry competence surgeon, problems still apparently random also best hands (17%). temporary mean occlusion time who suffered twice as long arrest blood flow performed aid dissection. Conclusions. results obtained series closely reflect overall management disease support conclusion that causing poor can be estimated large population-based scale. most common devastating complication occurred. Support found more liberal clips early dissection, regardless experience surgeon. Temporary regional interruption arterial should routine method surgery an everyday basis. occurrence difficult clearly shown, factor unpredictability, which is present any preoperative assessment risk, strengthens recommending neuroprotection adjunct virtually operation, surgeon's experience. (Less)