Analysis Surgical Outcomes of Ruptured Anterior Communicating Artery Aneurysm: Lateral Supraorbital Versus Pterional Approach.

Abstract

Objective To compare lateral supraorbital approach with pterional approach to determine the most effective routine to clip anterior communicating artery aneurysm.Method A total of 85 patients with anterior communicating artery aneurysm underwent surgical clipping, 34 through the lateral supraorbital approach and 51 through the pterional approach from June 2016 to June 2018 in the department of neurosurgery,Jinhua central hospital. We retrospectively analyzed the demographic and clinical variables including age, sex and Hunt-Hess grade. Accordingly, operative data, clinical outcome and postoperative complications were analyzed. The mRS at discharge and 6 months later were evaluated.Outcome All aneurysms were completely clipped. There was no significant difference in intraoperative aneurysm rupture rate and intensive care time between the two groups (P>0.05). Compared with the pterional approach, the operation time of the lateral approach was shorter, the amount of bleeding was less, and the bone flap was small, and there was a statistical difference (P<0.05). There was no statistically significant difference in complications between the two groups (P <0.05). There was no significant difference in mRS between the two groups at different time points (P>0.05). There was no significant difference in hospital stay between the two groups (P>0.05).Conclusion According to our results, we recommend the lateral supraorbital approach for ACoAA and A1/A2 to neurosurgeons who have gained sufficient experience due to its advantages over the pterional approach.