Classification of aneurysms of the internal carotid system

Abstract

Microsurgery has improved the treatment of cerebral aneurysms techically and by more detailed knowledge of the topographic relations, the variations, and the anomalies of the involved arteries. A personal study of 450 aneurysms formed the basis of a modified and more detailed classification of aneurysms of the carotid system. It was confirmed that aneurysms originate at the junctions of arteries, and generally project according to the course of the vessel involved. The origins and projections aneurysms and their different sites were analyzed with the aid of angiography, angiotomography, magnification angiography, operative drawings, photographs, and films, which permitted the establishment of a special classification for every particular form. Preoperative knowledge of the types of aneurysms facilitates the surgical procedures and results in lowered morbidity.

Usefulness of a Simplified Management Scheme for Paraclinoid Aneurysms Based on a Modified Classification

“…There is still no widely accepted classification of paraclinoid aneurysms used for the selection of management strategies, though some were proposed and several specific locations have been described [1,2,3,4,5,6,7,8,9,10,11,12,13,14]. The 5 categories, dorsal carotid, ventral carotid, ‘true’ ophthalmic, carotid cave and intracavernous, are the commonly used location descriptions [7].…”

“…In these settings, a pragmatic management scheme should be built up based on a classification for paraclinoid aneurysms. A few categorizations have been proposed [1,2,3,4,5,6,7,8,9,10,11,12,13,14], but they rarely corresponded to a treatment strategy. Therefore, the aim of our work was to set up a modified classification for paraclinoid aneurysms that will determine the management protocol to be applied.…”

Surgical Neuroangiography

“…Due to the location, anatomical configuration, and the frequent large size of the aneurysm at the time of clinical presentation, primary surgery is usually not possible (Drake 1979, Oller 1976, Pia 1978. Due to the location, anatomical configuration, and the frequent large size of the aneurysm at the time of clinical presentation, primary surgery is usually not possible (Drake 1979, Oller 1976, Pia 1978.…”

Internal Carotid Artery Reconstruction Using Multiple Fenestrated Clips for Complete Occlusion of Large Paraclinoid Aneurysms

“…These paraclinoid aneurysms are classified based on complex relationships between the aneurysm sac, dura, branching arteries, and anterior clinoid process2,3,8,14,18,19,28,29). Advancements in endovascular and microsurgical techniques have substantially improved the completeness of aneurysm sac obliteration operations and the treatment outcomes of paraclinoid aneurysms5,8,9,15,16,18,30,33,35,39).…”