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A Pooled Analysis of Cerebral Monitoring in Aneurysm Surgery: Evaluating Clinical Outcomes

Friday, May 3, 2024

    Presenting Author(s)

  • Marcio Yuri Ferreira, MD

    Research Collaborator
    Program in Global Surgery and Social Change - Harvard Medical School. Postgraduate Program in Translational Surgery of Federal University of São Paulo, Brazil

    • Co-Author(s)

  • Filipi Andreão

    Medical Student
    Federal University of Rio de Janeiro
    Rio de Janeiro, RJ, BR

  • SB

    Savio Batista, n/a

    Medical student
    Federal University of Rio de Janeiro, United States

  • JB

    Jhon Bocanegra, n/a

    Doctor
    Universidad Peruana Cayetano Heredia, Lima, Peru, United States

  • JS

    João Pedro Sanches, n/a

    Medical student
    Federal University of Rio de Janeiro, United States

Introduction: In aneurysm surgery, ensuring safety and precision is crucial. Intraoperative monitoring is an important tool for real-time assessment and patient well-being. This study aims to elucidate the role of intraoperative monitoring in aneurysm surgery by assessing its impact on safety and efficacy outcomes. Additionally, we aim to compare the effectiveness of dual monitoring modalities versus a single modality.

Methods: A search following PRISMA-guidelines was conducted across Medline, Embase, and Web of Science databases to identify studies on the use of intraoperative monitorization for aneurysm management. For the analysis of the outcomes (postoperative deficits, complications, and mortality were accessed) we performed two single arm meta-analysis, for single and dual intraoperative monitorization of aneurysm surgery.

Results: Regarding postoperative motor and neurological deficits, the single monitorization showed a rate of 5% (0%-12%; I²=71%) and 6% (1%-10%; I²=59%), respectively, and the dual monitorization a rate of 21% (0%-51%; I²=97%) and 23% (0%-50%; I²=98%), respectively. For complications, the single monitorization rate found to be 7% (3%-12%; I²=91%) and the dual monitorization 7% (3%-11%; I²=94%). There were no mortality events in both groups.

Conclusion : In conclusion, while single monitoring exhibits lower rates of postoperative motor and neurological deficits, both approaches demonstrate effective prevention of complications, with comparable rates. This underscores the effectiveness of single monitoring and prompts consideration regarding the necessity of the additional cost associated with dual monitoring when single monitoring produces comparable or even superior results. The absence of any mortality events in either group underscores the overall safety of these monitoring techniques. Further research in this area may help refine monitoring protocols and further enhance the quality of care in aneurysm surgery.