Subtemporal Approach to Posterior Cerebral Artery Aneurysms

Posterior Cerebral Artery Aneurysms: Treatment and Outcome Analysis in 121 Patients

“…These proximal segments are surgically accessible by standard frontotemporal or subtemporal approaches and endovascular techniques are also applicable. 1,4,7,16,17,19,28 In particular, PCA aneurysms distal to the circle of Willis have nearly identical rupture rates (38% vs. 37%). However, their deep anatomic location close to sensitive neuroanatomic structures and a long intravasal route to the terminal segments of the posterior circulation make treatment more challenging.…”

“…27 Surgical approaches, such as the subtemporal, pterional, orbitozygomatic, supracerebellar transtentorial, and posterior interhemispheric approaches, have been described for microsurgical management of aneurysms on various PCA segments. 1,6,17,21,28,29 However, during the last 3 decades, endovascular techniques have evolved rapidly and PCA aneurysms close to the brainstem are also treated using endovascular techniques. 4,7,16,30 We present a consecutive series of 121 patients with 135 PCA aneurysms treated between 1980 and 2014 at the 2 given neurosurgical centers, which are responsible for a population of approximately 2.8 million people.…”

40 Posterior Cerebral Artery Aneurysms

“…These proximal segments are surgically accessible by standard frontotemporal or subtemporal approaches and endovascular techniques are also applicable. 1,4,7,16,17,19,28 In particular, PCA aneurysms distal to the circle of Willis have nearly identical rupture rates (38% vs. 37%). However, their deep anatomic location close to sensitive neuroanatomic structures and a long intravasal route to the terminal segments of the posterior circulation make treatment more challenging.…”

“…The most common approaches for these aneurysms are the frontotemporal and subtemporal approaches. 1,6,28,29,32 However, the most frequent complications were not related to the microsurgical approach itself but more to the chosen strategy. Endovascular treatment was used for 17 patients with 20 PCA aneurysms, but the primary aneurysm occlusion rate was only 70%, compared with 90% in the microsurgical group.…”

“…27 Surgical approaches, such as the subtemporal, pterional, orbitozygomatic, supracerebellar transtentorial, and posterior interhemispheric approaches, have been described for microsurgical management of aneurysms on various PCA segments. 1,6,17,21,28,29 However, during the last 3 decades, endovascular techniques have evolved rapidly and PCA aneurysms close to the brainstem are also treated using endovascular techniques. 4,7,16,30 We present a consecutive series of 121 patients with 135 PCA aneurysms treated between 1980 and 2014 at the 2 given neurosurgical centers, which are responsible for a population of approximately 2.8 million people.…”