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Long‑term outcomes following the clipping of ruptured intracranial aneurysms of the anterior circulation: A retrospective institutional study

  • Authors:
    • Diamantoula Pagkou
    • George Fotakopoulos
    • Evangelos Kogias
    • Kiriaki Papadopoulou
    • Ioannis Patsalas
    • Nikolaos Foroglou
  • View Affiliations / Copyright

    Affiliations: Department of Neurosurgery, AHEPA University Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
    Copyright: © Pagkou et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].
  • Article Number: 58
    |
    Published online on: July 31, 2025
       https://doi.org/10.3892/mi.2025.257
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Abstract

Aneurysmal subarachnoid hemorrhage (SAH) constitutes a devastating and life‑threatening neurosurgical emergency. Over a number of years, there has been a debate as regards the most suitable timing for surgery. The present retrospective study aimed to investigate the association between the timing of treatment and the outcomes of patients who underwent clipping of ruptured intracranial aneurysms. The present study performed a retrospective analysis of 92 of 142 consecutive patients who were diagnosed with anterior circulation ruptured aneurysms and treated only by microsurgical clipping between January, 2013 and December, 2018. The patients were divided into two groups, namely group A, which included patients who underwent microsurgical clipping for ruptured anterior circulation aneurysm in the early stages (within the first 3 days of aneurysm rupture occurrence), and group B, which included those who were operated on in the late stages (after 3 days of aneurysm rupture occurrence). The age of the patients ranged from 26 to 78 years, with a mean age of 54.6 years. In total, 52 patients were female (56.6%) and 40 patients were male (43.4%). Risk factors associated with a high incidence of rupture included hypertension in 47 (51.0%) patients, cigarette smoking in 39 (42.3%) patients, alcohol consumption in 20 (21.7%) patients and diabetes mellitus in 2 (2.1%) patients. The present study revealed that the mortality rate was lower in group B (P=0.011; 4.3% compared with 11.9% in group A). This indicates that particularly the timing of surgery in group B (patients who were operated on in the late stages, after 3 days of aneurysm rupture occurrence) was more appropriate. In addition, no complications, post‑operative hemiplegia and mortality were all independent factors associated with good outcomes (≥2 modified Rankin scale) (P<0.05 for all three parameters). On the whole, the present study demonstrates that the outcomes of patients who underwent microsurgical clipping for ruptured anterior circulation aneurysms ≥3 days after admission or rupture occurrence, exhibited favorable outcomes compared to patients operated on during the first 2 days of occurrence.
View Figures

Figure 1

Flow chart of the inclusion process
for the participants in the present study.

Figure 2

ROC curve for no complications,
predicting good outcome (>2 mRS) during follow-up. AUC, 0.828.
ROC, receiver operative characteristic; AUC, area under the
curve.

Figure 3

ROC curve for mortality, predicting
good outcome (≥2 mRS) during follow-up. AUC, 0742. ROC, receiver
operative characteristic; AUC, area under the curve.
View References

1 

Steiner T, Juvela S, Unterberg A, Jung C, Forsting M and Rinkel G: European Stroke Organization. European stroke organization guidelines for the management of intracranial aneurysms and subarachnoid haemorrhage. Cerebrovasc Dis. 35:93–112. 2013.PubMed/NCBI View Article : Google Scholar

2 

D'Souza S: Aneurysmal subarachnoid hemorrhage. J Neurosurg Anesthesiol. 27:222–240. 2015.PubMed/NCBI View Article : Google Scholar

3 

Petridis AK, Kamp MA, Cornelius JF, Beez T, Beseoglu K, Turowski B and Steiger HJ: Aneurysmal subarachnoid hemorrhage. Dtsch Arztebl Int. 114:226–236. 2017.PubMed/NCBI View Article : Google Scholar

4 

Fotakopoulos G, Tsianaka E, Fountas K, Makris D, Spyrou M and Hernesniemi J: Clipping versus coiling, in anterior circulation ruptured intracranial aneurysms: A meta-analysis. World Neurosurg. 104:482–488. 2017.PubMed/NCBI View Article : Google Scholar

5 

Fotakopoulos G, Andrade-Barazarte H, Tjahjadi M, Goehre F and Hernesniemi J: Clipping versus coiling in ruptured basilar apex aneurysms: A meta-analysis. Turk Neurosurg. 31:301–309. 2021.PubMed/NCBI View Article : Google Scholar

6 

Tsolaki V, Aravantinou-Fatorou A, Georgakopoulou VE, Spandidos DA, Papalexis P, Mathioudakis N, Tarantinos K, Trakas N, Sklapani P and Fotakopoulos G: Early diagnosis of cerebral vasospasm associated with cerebral ischemia following subarachnoid hemorrhage: Evaluation of computed tomography perfusion and transcranial doppler as accurate methods. Med Int (Lond). 2(34)2022.PubMed/NCBI View Article : Google Scholar

7 

Fotakopoulos G, Makris D, Kotlia P, Kapsalaki E, Papanikolaou J, Georgiadis I, Zakynthinos E and Fountas K: The value of computed tomography perfusion & transcranial Doppler in early diagnosis of cerebral vasospasm in aneurysmal & traumatic subarachnoid hemorrhage. Future Sci OA. 4(FSO313)2018.PubMed/NCBI View Article : Google Scholar

8 

Zhang Y, Zhu X, Hou K, Zhao J, Gao X, Sun Y, Wang W and Zhang X: Clinical outcomes of surgical clipping for intracranial aneurysms in patients with a Hunt and Hess grade 4 or 5. Arq Neuropsiquiatr. 74:478–481. 2016.PubMed/NCBI View Article : Google Scholar

9 

Fotakopoulos G, Andrade-Barazarte H, Alexandros B and Hernesniemi J: A meta-analysis of lateral supraorbital vs. mini pterional approach in the outcome of rupture and unruptured noncomplex aneurysms' surgery. Neurocirugia (Engl Ed). 34:128–138. 2023.PubMed/NCBI View Article : Google Scholar

10 

Fotakopoulos G, Georgakopoulou VE, Gatos C, Christodoulidis G and Foroglou N: Microsurgery treatment as an optimal management of posterior cerebral artery aneurysms: A systematic review and meta-analysis. Cureus. 17(e77856)2025.PubMed/NCBI View Article : Google Scholar

11 

Mohammad F, Horiguchi T, Mizutani K and Yoshida K: Clipping versus coiling in ruptured aneurysms of the anterior cerebral circulation. Open J Mod Neurosurg. 10:88–104. 2020.

12 

Ahmed SI, Javed G, Bareeqa SB, Samar SS, Shah A, Giani A, Aziz Z, Tasleem A and Humayun SH: Endovascular coiling versus neurosurgical clipping for aneurysmal subarachnoid hemorrhage: A systematic review and meta-analysis. Cureus. 11(e4320)2019.PubMed/NCBI View Article : Google Scholar

13 

Dellaretti M, Batista DM, de Almeida JC, de Souza RF, Ronconi DE, de Almeida CER, Fontoura RR and Júnior WF: Surgical treatment of ruptured intracranial aneurysms: Timing of treatment and outcome. Interdiscip Neurosurg. 14:178–182. 2018.

14 

Yao Z, Hu X, Ma L, You C and He M: Timing of surgery for aneurysmal subarachnoid hemorrhage: A systematic review and meta-analysis. Int J Surg. 48:266–274. 2017.PubMed/NCBI View Article : Google Scholar

15 

Weil AG and Zhao JZ: Treatment of ruptured aneurysms: Earlier is better. World Neurosurg. 77:263–265. 2012.PubMed/NCBI View Article : Google Scholar

16 

Duangthongphon P, Souwong B, Munkong W and Kitkhuandee A: Results of a preventive rebleeding protocol in patients with ruptured cerebral aneurysm: A retrospective cohort study. Asian J Neurosurg. 14:748–753. 2019.PubMed/NCBI View Article : Google Scholar

17 

Drake CG: Progress in cerebrovascular disease. Management of cerebral aneurysm. Stroke. 12:273–283. 1981.PubMed/NCBI View Article : Google Scholar

18 

Nieuwkamp DJ, de Gans K, Algra A, Albrecht KW, Boomstra S, Brouwers PJAM, Groen RJM, Metzemaekers JDM, Nijssen PCG, Roos YBWEM, et al: Timing of aneurysm surgery in subarachnoid haemorrhage-an observational study in The Netherlands. Acta Neurochir (Wien). 147:815–821. 2005.PubMed/NCBI View Article : Google Scholar

19 

Broderick JP, Adeoye O and Elm J: Evolution of the modified rankin scale and its use in future stroke trials. Stroke. 48:2007–2012. 2017.PubMed/NCBI View Article : Google Scholar

20 

Mahaney KB, Todd MM and Torner JC: IHAST Investigators. Variation of patient characteristics, management, and outcome with timing of surgery for aneurysmal subarachnoid hemorrhage. J Neurosurg. 114:1045–1053. 2011.PubMed/NCBI View Article : Google Scholar

21 

Chyatte D, Fode NC and Sundt TM Jr: Early versus late intracranial aneurysm surgery in subarachnoid hemorrhage. J Neurosurg. 69:326–231. 1988.PubMed/NCBI View Article : Google Scholar

22 

Dorhout Mees SM, Molyneux AJ, Kerr RS, Algra A and Rinkel GJE: Timing of aneurysm treatment after subarachnoid hemorrhage: Relationship with delayed cerebral ischemia and poor outcome. Stroke. 43:2126–2129. 2012.PubMed/NCBI View Article : Google Scholar

23 

Zhao C and Wei Y: Surgical timing for aneurysmal subarachnoid hemorrhage: A meta-analysis and systematic review. Turk Neurosurg. 27:489–499. 2017.PubMed/NCBI View Article : Google Scholar

24 

Kassell NF and Drake CG: Timing of aneurysm surgery. Neurosurgery. 10:514–519. 1982.PubMed/NCBI View Article : Google Scholar

25 

Lawson MF, Chi YY, Velat GJ, Mocco JD and Hoh BL: Timing of aneurysm surgery: The international cooperative study revisited in the era of endovascular coiling. J Neurointerv Surg. 2:131–134. 2010.PubMed/NCBI View Article : Google Scholar

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Copy and paste a formatted citation
Spandidos Publications style
Pagkou D, Fotakopoulos G, Kogias E, Papadopoulou K, Patsalas I and Foroglou N: Long‑term outcomes following the clipping of ruptured intracranial aneurysms of the anterior circulation: A retrospective institutional study. Med Int 5: 58, 2025.
APA
Pagkou, D., Fotakopoulos, G., Kogias, E., Papadopoulou, K., Patsalas, I., & Foroglou, N. (2025). Long‑term outcomes following the clipping of ruptured intracranial aneurysms of the anterior circulation: A retrospective institutional study. Medicine International, 5, 58. https://doi.org/10.3892/mi.2025.257
MLA
Pagkou, D., Fotakopoulos, G., Kogias, E., Papadopoulou, K., Patsalas, I., Foroglou, N."Long‑term outcomes following the clipping of ruptured intracranial aneurysms of the anterior circulation: A retrospective institutional study". Medicine International 5.5 (2025): 58.
Chicago
Pagkou, D., Fotakopoulos, G., Kogias, E., Papadopoulou, K., Patsalas, I., Foroglou, N."Long‑term outcomes following the clipping of ruptured intracranial aneurysms of the anterior circulation: A retrospective institutional study". Medicine International 5, no. 5 (2025): 58. https://doi.org/10.3892/mi.2025.257
Copy and paste a formatted citation
x
Spandidos Publications style
Pagkou D, Fotakopoulos G, Kogias E, Papadopoulou K, Patsalas I and Foroglou N: Long‑term outcomes following the clipping of ruptured intracranial aneurysms of the anterior circulation: A retrospective institutional study. Med Int 5: 58, 2025.
APA
Pagkou, D., Fotakopoulos, G., Kogias, E., Papadopoulou, K., Patsalas, I., & Foroglou, N. (2025). Long‑term outcomes following the clipping of ruptured intracranial aneurysms of the anterior circulation: A retrospective institutional study. Medicine International, 5, 58. https://doi.org/10.3892/mi.2025.257
MLA
Pagkou, D., Fotakopoulos, G., Kogias, E., Papadopoulou, K., Patsalas, I., Foroglou, N."Long‑term outcomes following the clipping of ruptured intracranial aneurysms of the anterior circulation: A retrospective institutional study". Medicine International 5.5 (2025): 58.
Chicago
Pagkou, D., Fotakopoulos, G., Kogias, E., Papadopoulou, K., Patsalas, I., Foroglou, N."Long‑term outcomes following the clipping of ruptured intracranial aneurysms of the anterior circulation: A retrospective institutional study". Medicine International 5, no. 5 (2025): 58. https://doi.org/10.3892/mi.2025.257
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