Results of applying a personalized approach in microsurgery of cerebral aneurysms using supraorbital mini-craniotomy

Abstract

The purpose was to evaluate the results of applying supraorbital mini-craniotomy in the microsurgical treatment of cerebral aneurysms using a personalized approach, and compare the safety and efficacy of supraorbital mini-craniotomy with traditional pterional approach by means of the pseudo-randomization method. Materials and Methods. We conducted an analysis of the microsurgery results in 455 patients with cerebral aneurysms over the period from 2014 to 2023. The study included patients operated on using traditional pterional craniotomy (n=200, 43.9 %) and supraorbital mini-craniotomy (n=255, 56.04 %). We compared treatment outcomes in patients during the acute phase of rupture and in cases of unruptured aneurysms (UA). The safety and efficacy of the microsurgical treatment were assessed through the analysis of functional outcomes, aneurysm exclusion completeness, and perioperative complications. Additionally, the duration of the surgery and postoperative hospital stay were evaluated. Follow-up was conducted over a period ranging from 12 to 48 months. Results. Comparative analysis using the pseudo-randomization method in the acute period of subarachnoid hemorrhage (SAH) confirmed that the duration of surgery and postoperative hospital stay were comparable. In cases of UA, the duration of surgery and postoperative hospital stay were significantly shorter in the supraorbital mini-craniotomy group (p<0.002 and p=0.032, respectively). The completeness of aneurysm exclusion and functional outcomes were comparable in both groups (p>0.05). There was no statistically significant difference in the intra- and postoperative complications rates (p>0.05). Mortality rates were comparable in both groups. Conclusion. When using a personalized approach, supraorbital mini-craniotomy has safety and efficacy equivalent to traditional approach in the microsurgical treatment of cerebral aneurysms.