Endovascular management of giant aneurysms: An introspection

Zhang, Zhenhai; Lv, Xianli; Yang, Xiaoling; Mu, Shiqing; Wu, Zhongxue; Shen, Chunsen; Xu, Ran

doi:10.4103/0028-3886.156278

Cited by 10 publications

(2 citation statements)

References 30 publications

(39 reference statements)

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“…At the same time, large or giant aneurysms still have high recurrence and incomplete occlusion rates after interventional therapy because of their wide neck. 4,7,8 The technique of anterior clinoidectomy is a complex but essential skill for neurosurgical skull base surgeons, 9 and removal of the ACP can provide a better view and range of motion for the ON and ICA. The traditional subdural and epidural approaches require abrasion of the complete ACP, whose lateral edge of abrasion should reach the incisura supraorbitalis.…”

Section: Discussionmentioning

confidence: 99%

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Clipping Ophthalmic Segment Artery Aneurysms Using a Modified Subdural Dolenc Approach: Classification and Experience Sharing

Zhou

Wang²,

Zhan³

et al. 2022

Operative Neurosurgery

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BACKGROUND:Ophthalmic segment artery aneurysms (OSAs) are difficult to clip; therefore, improvement of the surgical method is of great significance to the prevention of complications, and the classification of the aneurysms is essential to formulate a reasonable surgical plan.OBJECTIVE:To explore the strategies and effects of surgery for OSAs using a modified subdural Dolenc approach.METHODS:The clinical data of 38 patients (12 men and 26 women, aged 48-73 years) with OSA were analyzed retrospectively. A total of 44 aneurysms were identified, 40 of which were OSAs. The 40 aneurysms were divided into types Ia1 (n = 2), Ia2 (n = 2), Ib (n = 6), IIa (n = 4), IIb (n = 4), IIIa (n = 0), IIIb (n = 4), IIIc (n = 16), and IV (n = 2) based on preoperative images. Thirty-nine OSAs were operated successfully through pterional craniotomy combined with the modified subdural Dolenc approach, and 1 aneurysm was clipped through the contralateral approach. Clinical outcomes were evaluated using the Glasgow Outcome Scale (GOS).RESULTS:Thirty-nine OSAs were clipped, and one was wrapped. Visual dysfunction, headache, and dizziness improved after the operation in 18 patients. One patient had new visual impairment, and there were no deaths. At discharge, the GOS score was 5 in 36 cases, 4 in 1 case, and 3 in 1 case. Thirty-seven patients had a GOS score of 5, and 1 patient had a score of 3 at 6 months after the operation.CONCLUSION:The modified subdural Dolenc approach (Zheng approach) for clipping OSAs may be associated with less trauma and good postoperative outcomes.

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Section: Discussionmentioning

confidence: 99%

“…At the same time, large or giant aneurysms still have high recurrence and incomplete occlusion rates after interventional therapy because of their wide neck. 4,7,8…”

Section: Discussionmentioning

confidence: 99%