Results of Microsurgical Treatment of Large and Giant ICA Aneurysms Using the Retrograde Suction Decompression (RSD) Technique: Series of 92 Patients

Intracranial hemorrhage from giant aneurysm in pregnancy: A rare association

“…[1016] Those with a ruptured aneurysm should have the aneurysm clipped/endovascularly treated as rapidly as possible. [171819202122] During such clipping, general hypotension should be avoided and reliance placed on temporary clips. Once the aneurysm is successfully clipped, the pregnancy can be allowed to progress to term and patient can be delivered vaginally if she is in good neurologic condition.…”

The Treatment of Large and Giant Paraclinoid Internal Carotid Artery Aneurysms

“…Nevertheless, several complications with this technique have been described: thromboembolism and vessel dissection can occur, and one group calculated a 16% complication rate [4]. In Eliava's report, 83 paraclinoid aneurysms were surgically treated with the RSD technique performed with the neck route (62 patients), or with endovascular means (21 patients) [5]. In 90.4% (75) of these RSD surgeries, the aneurysm was successfully removed, and 83.1% (69) of the patients showed good or excellent results (Glasgow Outcome Scale score of 4 or 5) at discharge.…”

Retrograde Suction Decompression for Clip Occlusion of Internal Carotid Artery Communicating Segment Aneurysms

“…3 Batjer and Samson 4 in 1990 and Tamaki et al 5 in 1991 described the surgical retrograde suction decompression (RSD) technique as an alternative to achieve proximal vascular control of the parent vessel, to improve the visualization of the aneurysm neck, and to reconstruct the parent vessel without occluding important perforators. 1,[4][5][6][7][8][9][10][11][12] Subsequently, the adoption of less invasive procedures has led to the use of the endovascular suction decompression technique as an option to surgical exposure; however, it carries a higher risk of ICA dissection. 1,[6][7][8][9]12 The surgical RSD technique has been applied mainly for large or giant aneurysms located in the ophthalmic (C2)/clinoid (C3) segment of the ICA, and less often for C1 aneurysms.…”

“…1,[4][5][6][7][8][9][10][11][12] Subsequently, the adoption of less invasive procedures has led to the use of the endovascular suction decompression technique as an option to surgical exposure; however, it carries a higher risk of ICA dissection. 1,[6][7][8][9]12 The surgical RSD technique has been applied mainly for large or giant aneurysms located in the ophthalmic (C2)/clinoid (C3) segment of the ICA, and less often for C1 aneurysms. 13 Previous case series of RSD-assisted clipping focused mainly on C2/C3 aneurysms or failed to show the results of RSD-assisted clipping for C1 aneurysms.…”

“…13 Previous case series of RSD-assisted clipping focused mainly on C2/C3 aneurysms or failed to show the results of RSD-assisted clipping for C1 aneurysms. 6,7 The present study analyzed 20 consecutive patients with C1 aneurysms treated through direct microsurgical clipping assisted by RSD to provide proximal control of the parent vessel to evaluate the surgical technique and feasibility of RSD for direct clipping of C1 aneurysms.…”