Intraoperative aneurysmal Rupture: Incidence, Cause, and Considerations in the Management

Lee, Hoon Kap; Song, Jun Hyeok

Abstract

Intraoperative aneurysmal rupture is an undesired event that not only interrupt surgical procedures but also has negative effects on surgical outcome. To define the incidence, cause, and management of the intraoperative aneurysmal rupture, a retrospective analysis was performed on patients with cerebral aneurysms operated from January 1990 to December 1994. A total of 292 aneurysmal patients were included in this study. There were 15 intraoperative aneurysmal ruptures(5.4%). Rupture occurred during predissection in 1 case, during the dissection in 8 cases, and during the clip application in 6 cases. Admission grade, size, location of aneurysm, operation timiming, and mean arterial pressure during the dissection did not have significant influence on the incidence of intraoperative rupture. The outcomes were worse in the patients with intraoperative rupture than in non-ruptured patients(p<0.05). The skills and experience of the surgeon, rather than the location of aneurysm, stage of rupture, and treatment methods, may be the more crucial factor that determine the surgical outcomes.