BACKGROUND: Treatment of very small unruptured @entity438 (VSUIAs, defined as  <=3 mm) can be indicated in selected circumstances. The feasibility and outcomes of endovascular therapy for VSUIAs have been recently published; however, the efficacy and complication rate of surgical clipping has not been reported in any large series to date. OBJECTIVE: We conducted a multicenter study to examine surgical outcomes for VSUIAs. METHODS: All consecutive @entity1 undergoing surgery for a VSUIA in 4 neurosurgical centers between October 2001 and December 2012 were retrospectively analyzed. RESULTS: In the study, 183 @entity1 (128 @entity1 , mean age 51.3 years) were treated with 190 procedures for a total of 228 @entity439 . Most were anterior circulation @entity439 (n = 215). The majority were directly clipped (n = 222, 97.4%), with coagulation or wrapping in the remainder. After 1 reoperation for incomplete clipping, postoperative imaging of 225 @entity439 confirmed complete occlusion in 221 (98.2%), 1 neck remnant (0.44%), and 3 partial occlusions (1.3%). Mortality was 0%. Early postoperative @entity51 developed in 12 @entity1 (6.6%); posterior circulation location was a significant risk factor for early @entity51 (P < .001). Middle cerebral @entity438 had the lowest rate of @entity86 at 1.5% (P = .023). After the initial 30-day perioperative period, all deficits related to treatment of posterior circulation @entity439 recovered; overall @entity16 decreased to 2.7% with no mortality. CONCLUSION: VSUIA clipping is highly effective and is associated with a low morbidity rate. For VSUIAs selected for treatment, our data support surgical clipping as the modality of choice. ABBREVIATIONS: BA, basilar arteryDSA, digital subtraction angiographyM1, middle cerebral artery proximal segmentMCA, middle cerebral arterymRS, modified Rankin ScaleSCA, superior cerebellar arterySAH, @entity510 , very small unruptured @entity438 .

Surgical Clipping of Very Small Unruptured XXXX : A Multicenter International Study.

@entity1 :: ('9606', 'Species') :: ['women', 'patients'] @entity510 :: ('MESH:D013345', 'Disease') :: ['subarachnoid hemorrhageVSUIAs'] @entity16 :: ('MESH:D009422', 'Disease') :: ['neurological morbidity'] @entity51 :: ('MESH:D009461', 'Disease') :: ['neurological deficit'] @entity439 :: ('MESH:D000783', 'Disease') :: ['aneurysms'] @entity86 :: ('MESH:D019106', 'Disease') :: ['postoperative deficits'] @entity438 :: ('MESH:D002532', 'Disease') :: ['artery aneurysms', 'intracranial aneurysms']
@entity438 :: (MESH:D002532,Disease) :: ['Intracranial Aneurysms']
