Optimizing surgical approaches for anterior communicating artery aneurysms: Development and internal validation of a novel surgical scoring system

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dc.authoridSimsek, Osman/0000-0002-8716-5187
dc.authoridOrakdogen, Metin/0000-0002-9395-2902
dc.authorwosidSimsek, Osman/D-4906-2012
dc.contributor.authorOrakdogen, Metin
dc.contributor.authorMammadkhanli, Orkhan
dc.contributor.authorSimsek, Osman
dc.date.accessioned2024-06-12T10:50:28Z
dc.date.available2024-06-12T10:50:28Z
dc.date.issued2024
dc.departmentTrakya Üniversitesien_US
dc.description.abstractBackgroundThe objective was to provide comprehensive preoperative information on both the aneurysm orientation and the side and method of surgical approach for optimal preoperative information and safe clipping using 3D imaging modalities. This was achieved by making an objective risk assessment on the surgical side/method and evaluating its effectiveness with internal validation.Materials and methodsRadiologic data of 61 ACoA aneurysm patients between 2012 and 2020 were retrospectively analyzed. A scoring system based on five criteria; ACoA aneurysm dome orientation, A1 symmetry/control, perforating artery control, A2 trace orientation, and A2 fork symmetry was developed. The system is designed to align with the most common surgical approaches in ACoA aneurysm surgery. The patients were categorized into three groups based on the scoring results to determine the most appropriate surgical method. Group I was recommended, Group II was less recommended, and Group III was least recommended. Internal validation was performed to assess the system's effectiveness. Outcomes and complication rates were statistically evaluated.ResultsWhen the scoring system was utilized, the mean score difference between the first group and the other groups was 2.71 and 4.62, respectively. There was a homogeneous distribution among the groups in terms of age, sex, WFNS, and Fisher scores. Complication occurred in three patients in Group I and nine patients each in Group II and Group III. The further the deviation from the first option, the higher the complication rate (p = 0.016), and a significant cause-effect relationship was identified (p = 0.021). The ROC curve established a cut-off value of 12.5 points for complications and outcomes.ConclusionOur study introduces a new scoring system for ACoA aneurysms, enhancing the use of 3D CTA in daily practice and providing internal validation for the proposed approach. By evaluating objective criteria, this scoring system helps predict surgical risks, prevent complications, and supports personalized evaluation and selection of the surgical approach based on objective criteria.en_US
dc.description.sponsorshipTrakya Universityen_US
dc.description.sponsorshipThe authors express their gratitude to Ahmet Tolgay Akinci, MD, PhD (c), for conducting the statistical analysis.en_US
dc.identifier.doi10.1007/s10143-024-02344-w
dc.identifier.issn0344-5607
dc.identifier.issn1437-2320
dc.identifier.issue1en_US
dc.identifier.pmid38499891en_US
dc.identifier.scopus2-s2.0-85188140471en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.urihttps://doi.org/10.1007/s10143-024-02344-w
dc.identifier.urihttps://hdl.handle.net/20.500.14551/18001
dc.identifier.volume47en_US
dc.identifier.wosWOS:001186546000001en_US
dc.identifier.wosqualityN/Aen_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherSpringeren_US
dc.relation.ispartofNeurosurgical Reviewen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectAcoa Aneurysmen_US
dc.subjectSurgical Scoring Systemen_US
dc.subject3D CTAen_US
dc.subjectAneurysm Clippingen_US
dc.subjectRuptured Anterioren_US
dc.subjectEndovascular Therapyen_US
dc.subjectPterional Approachen_US
dc.subjectSideen_US
dc.subjectManagementen_US
dc.subjectAnatomyen_US
dc.subjectNecken_US
dc.titleOptimizing surgical approaches for anterior communicating artery aneurysms: Development and internal validation of a novel surgical scoring systemen_US
dc.typeArticleen_US

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