Clinical ReportComplications and Postoperative Care in Patients Undergoing Treatment for Unruptured Intracranial AneurysmsNiskanen, Minna MD PhD*; Koivisto, Timo MD, PhD†; Rinne, Jaakko MD PhD†; Ronkainen, Antti MD PhD†; Pirskanen, Sanna‡; Saari, Tapani MD§; Vanninen, Ritva MD PhD§Author Information From the *Department of Anesthesiology and Intensive Care, Kuopio University Hospital, Kuopio, Finland; †Department of Neurosurgery, Kuopio University Hospital, Kuopio, Finland; ‡University of Kuopio, Kuopio, Finland; §Department of Radiology, Kuopio University Hospital, Kuopio, Finland. Received for publication December 2, 2004; accepted February 24, 2004. Reprints: Dr. Minna Niskanen, Anesthesiology and Intensive Care, ENT-Hospital, Helsinki University Central Hospital, P.O. Box 220, FIN-00029 HUS, Finland (E-mail: [email protected]). Journal of Neurosurgical Anesthesiology: April 2005 - Volume 17 - Issue 2 - p 100-105 doi: 10.1097/01.ana.0000163202.33236.mL Buy Metrics Abstract Endovascular treatment has become a feasible alternative in the management of aneurysmal subarachnoid hemorrhage. After endovascular or surgical treatment of patients with unruptured intracranial aneurysms (UIAs), little is known about the practices of observation or need for intensive care. We analyzed retrospectively perioperative complications that were associated with the procedure and postoperative care in patients undergoing management of UIAs. A total of 53 patients underwent endovascular treatment and 105 patients surgical treatment. Location of the aneurysm was the main determinant of the modality of treatment. In the endovascular group, 34 patients were conscious during the procedure and 19 were under general anesthesia. Six patients in the endovascular and 9 in the surgical group experienced complications during the procedure. After the procedure, complications were more common in the surgical group than in the endovascular group (11 versus 0 patients, P = 0.015). Six of the postoperative complications of surgically treated patients occurred in the intensive care unit. Two patients in the endovascular group and five in the surgical group had major neurologic deficits as a consequence of complications. One surgically treated patient died. Both endovascular and surgical treatment of UIAs carry risks that may result in severe neurologic impairment. Patients should be observed with equal vigilance with either treatment option. Surgical treatment is associated with emergencies that require prompt interventions postoperatively and therefore close observation in an ICU setting may be preferable in patients who have undergone surgical treatment of UIAs. Complications after uneventful endovascular procedures seem to be rare. © 2005 Lippincott Williams & Wilkins, Inc.