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Management of Intraoperative Rupture

Last Updated: September 28, 2018

Intraoperative Rupture of an MCA Aneurysm during Exposure (Pre-Dissection phase) without Proximal Control

With advances in endovascular therapy for intracranial aneurysms, patients with increasingly complex aneurysms are being referred for microsurgical procedures. As a result, the skills and outcomes of the neurovascular surgeon are under close scrutiny.

One of the most dramatic and potentially devastating complications during aneurysm microsurgery is intraoperative rupture (IOR). Containment of IOR and its sequel can make important contributions to minimizing complications from microsurgery. The incidence of IOR has been reported in 7% to 35% of cases. Several factors are associated with IOR: the surgeon’s experience, aneurysm size and morphology, and history of rupture.

Notably, th...