Multidisciplinary management of intracranial aneurysms: The experience of Lille university hospital center

Background. - In recent years, the multidisciplinary approach has become an important concern for the management of intracranial aneurysms. Objective. - This study aims to evaluate the functional outcomes of patients treated for an intracranial aneurysm (ruptured or unruptured), when the treatment modality was defined in a multidisciplinary fashion. Materials and methods. - In this retrospective study, we included all patients (n =209) treated for an intracranial saccular aneurysm at Lille university hospital between January 2009 and December 2009. There were 70 men and 139 women with a mean age of 50.5 years (range 24 to 73 years). The clinical data were recorded before treatment including the American Society of Anesthesiology (ASA) and the World Federation of Neurosurgical Societies (WFNS) scores. Microsurgical approach was performed in 110 patients whereas 99 patients underwent an endovascular procedure. A modified Rankin Scale (mRS) was reported at 3 months after treatment. Intracranial vascular imaging was performed before and immediately after the treatment and then renewed at 3 years in all patients to detect any recurrence. Results. - Among the 121 patients with ruptured aneurysm, the functional outcomes were similar between patients who underwent microsurgery and patients who had an endovascular treatment. In the 88 patients with an unruptured aneurysm, functional outcomes were also similar between the two treatment modalities. Among the 99 patients treated by the endovascular approach, 4 had a significant aneurysm reopening on follow-up imaging leading to additional treatment (3 clipping, I coiling). No aneurysm recurrence was reported among the 110 patients who underwent microsurgical treatment. Conclusion. - In a trained team, the multidisciplinary approach appears to be a valuable strategy in the management of intracranial aneurysms, to achieve good functional outcomes. (C) 2014 Elsevier Masson SAS. All rights reserved.