Effectiveness and safety of the Sugita clip for ruptured and unruptured intracranial aneurysms: A retrospective cohort study.

BACKGROUND

The long-term outcomes, adverse events, and occlusion rates of the Sugita clip remain unknown. This study evaluated the effectiveness and safety of the Sugita clip by assessing its outcomes and related complications.

METHODS

Patients who underwent cerebral aneurysm clipping for ruptured or unruptured cerebral aneurysms using the Sugita clip at Nagoya University Hospital and its affiliated facilities between January 01, 2016, and December 31, 2017, were enrolled. We retrospectively investigated patient background, operative information, intraoperative and perioperative complications, device malfunctions, occlusion and parent artery patency rates, and postoperative modified Rankin scale (mRS). We divided patients into two groups based on postoperative mRS to investigate factors that cause deterioration in neurological prognosis.

RESULTS

In total, 228 patients with unruptured intracranial aneurysms (UIAs) and 364 with ruptured intracranial aneurysms (RIAs) were included. Concerning postoperative mRS (91-365 days), 223 patients with UIAs and 258 with RIAs had good outcomes (mRS 0-2). Regarding device safety, there were no reports of aneurysm recurrence, parent artery occlusion due to clip slippage, foreign body reactions in the surrounding brain tissue, or device malfunctions. Factors that affected neurological outcomes in UIAs included perioperative hemorrhagic and ischemic complications. Contrastingly, in RIAs, age, Hunt and Kosnik grade, World Federation of Neurosurgical Societies (WFNS) grade, and perioperative ischemic complications were found to affect neurological prognosis.

CONCLUSION

Postoperative mRS of patients who underwent aneurysm surgery using the Sugita clip was comparable to that of global treatment, with no device-related complications, supporting the effectiveness and safety of the Sugita clip.