Surgical management of aneurysms of the bifurcation of the internal carotid artery

Miyazawa, Nobuhiko; Nukui, Hideaki; Horikoshi, Toru; Yagishita, Tsutomu; Sugita, Michiaki; Kanemaru, Kazuya

doi:10.1016/s0303-8467(01)00195-0

Cited by 34 publications

(29 citation statements)

References 31 publications

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“…This rate is comparable with that of patients who were clipped in 2 larger series (59% in Miyazawa et al's series and 69% in Gupta et al's) (8,16). Our data suggests that stent placement for ICA bifurcation aneurysms also seems to be safe.…”

Section: Selection Of Stenting Strategysupporting

confidence: 82%

“…Internal carotid artery (ICA) bifurcation aneurysms are uncommon, only accounting for about 2%-9% of intracranial aneurysms (11,16,19,22). Clipping is challenging for neurosurgeons due to their deep location, and vital perforators surrounding or adherent to the aneurysms (8,11,16).…”

Section: Discussionmentioning

confidence: 99%

“…Clipping is challenging for neurosurgeons due to their deep location, and vital perforators surrounding or adherent to the aneurysms (8,11,16). In one larger series, only 68.6% (48/70) of the reported patients had favorable outcome (good recovery or moderate disability) (8).…”

Section: Discussionmentioning

confidence: 99%

“…This is especially true for internal carotid artery (ICA) bifurcation aneurysms since clipping is challenging due to its deep locations and vital perforators surrounding or adherent to the aneurysms (8,11,16).…”

Section: Introductionmentioning

confidence: 99%

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Stent placement for the treatment of complex internal carotid bifurcation aneurysms: a review of 16 cases

Zhou¹,

Yang²,

Hong³

et al. 2012

Turkish Neurosurgery

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AIm: Stent placements for the treatment of complex internal carotid bifurcation aneurysms are not well documented yet. In this article, we reported a series of 16 such cases to evaluate the feasibility, safety and effectiveness of stent placement for these particular lesions. results: Sixteen stents, including 10 Enterprise, 4 Neuroform, 1 Solitaire and 1 one balloon-mounted coronary stent (BX), were successfully deployed in this series. Immediate angiogram showed complete occlusion in 5, neck remnant in 2 and residual sac in 9. No procedure-related complication occurred. Angiographic follow-up results (mean, 12.1months) were available in 15 patients, 9 of the aneurysms were cured, 1 was improved, 3 were stable, 2 were recanalized, and 1 was retreated. Clinical follow-up (mean, 28.6months) of all 16 patients demonstrated no neurologic deterioration or rebleeding.COnClusIOn: Our result suggests that stent placement for the treatment of complex ICA bifurcation aneurysms is feasible and safe. However, its efficacy should be further evaluated by larger case series and more adequate follow-up. BulGulAr: 10 Enterprise, 4 Neuroform, 1 Solitaire ve 1 balona monte edilmiş koroner stent (BX) dahil olmak üzere 16 stent bu seride başarıyla yerine yerleştirildi. Hemen yapılan anjiyogram 5'inde tam oklüzyon, 2'sinde kalan boyun kısmı ve 9'unda rezidüel kese gösterdi. İşlemle ilgili komplikasyon oluşmadı. Anjiyografik takip sonuçları (ortalama 12,1 ay) 15 hastada mevcuttu ve anevrizmaların 9'u tamamen iyileşmişti, 1'i daha iyiydi, 3'ü stabildi, 2'sinde tekrar kanalizasyon vardı ve 1'i tekrar tedavi edildi. Klinik takip (ortalama 28,6 ay) 16 hastanın hiçbirinde nörolojik bozulma veya tekrar kanama göstermedi. sOnuÇ: Sonucumuz kompleks IKA bifurkasyon anevrizmaları için stent yerleştirmenin kullanılabilir ve güvenli olduğunu düşündürmektedir. Ancak etkinliği daha büyük vaka serilerinde ve yeterli takiple daha ileri olarak değerlendirilmelidir.

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Section: Selection Of Stenting Strategysupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Stent placement for the treatment of complex internal carotid bifurcation aneurysms: a review of 16 cases

Zhou¹,

Yang²,

Hong³

et al. 2012

Turkish Neurosurgery

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“…The mean GCS score just before entering surgery was 12.5±2.5 (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). When the patients were evaluated, 21 patients were WFNS grade 1, 5 patients were grade 2, 4 patients were grade 3, 3 patients were grade 4 and 5 patients were grade 5.…”

Section: Discussionmentioning

confidence: 99%

Microsurgical clipping of anterior circle of willis aneurysms: a retrospective study

Eren¹,

Güzey²,

Yücel³

et al. 2017

Bagcilar Medical Bulletin

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Objective: The surgical outcomes of anterior circle of Willis aneurysms were evaluated. Material and Methods: Between March 2015 and December 2016, 38 patients were operated and followed up for aneurysms. There were 15 female and 23 male patients with a mean age of 47 years (range: 17-78). Of the patients, 35 were diagnosed with subarachnoid hemorrhage (SAH). Of these patients, 54.2% (n=19) were operated within the first 24 hours. All patients were operated by the same surgeon with sylvian dissection. All clinical data in the hospital charts and outpatient records and radiological investigations stored in the archive were evaluated retrospectively. Results:The most commonly seen aneurysm was on the anterior communicating artery (44.8%). After that, aneurysms on the middle cerebral artery (31.6%), posterior communicating artery (13.2%), internal cerebral artery bifurcation (7.8%), and distal anterior cerebral artery were seen, respectively. There was a significant correlation between the location of the aneurysm and the mean age (p=0.009). All patients were followed in the intensive care unit after operation. After surgery, vasospasm was observed in 26.3% of patients. Patients with high SAH grade developed vasospasm significantly more frequently (p=0.03). Neurological examinations at discharge were normal in 17 patients with SAH and 3 patients without SAH. Four patients were discharged with minimal neurological deficit and 2 patients with severe deficit. Eight patients with World Federation of Neurosurgical Societies (WFNS) grade 4-5, 2 patients with grade 3, and 2 patients with grade 1-2 were lost. Postoperative Glasgow Coma Scale and SAH WFNS grades were found to be determinants for dying. Conclusion: Despite the development of endovascular techniques in the treatment of aneurysm, microsurgical clipping remains the first choice method to treat anterior system aneurysms. Closure of the aneurysm is the treatment priority. It is well known that early surgery reduces mortality and morbidity. Keywords: aneurysm, clip, aneurysm surgery, microsurgical clipping, subarachnoid hemorrhage, circle of Willis ÖZET Willis poligonu anterior dolaşım anevrizmalarının mikroşirurjikal yöntemle klipslenmesi: Retrospektif çalışmaAmaç: Willis poligonu anterior sistem anevrizmalarının cerrahi sonuçlarının değerlendirilmesi. Yöntem ve Gereçler: Mart 2015-Aralık 2016 arasında intrakranyal anevrizma nedeniyle kliniğimizde ardı ardına 38 hasta ameliyat edildi. On beş kadın ve 23 erkek hastanın yaş ortalaması 47 (aralığı: 17-78) idi. Otuz beş hastada subaraknoid kanama (SAK) vardı ve bunların %54,2'si (n=19) ilk 24 saatte ameliyata alındı. Hastalar aynı cerrah tarafından silviyan diseksiyon yöntemi kullanılarak opere edildi. Çalışmamız klinik kayıt ve radyolojik görüntü arşivleri kullanılarak retrospektif olarak gerçekleştirildi. Bulgular: En fazla anterior komminikan arter anevrizması görüldü (44.8%). Sonra sırasıyla middle serebral arter (31.6 %), posterior komunikan arter (13.2 %), internal serebral arter (7.8%) ve distal anteri...

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Intracranial Aneurysms and Subarachnoid Hemorrhage

Harrigan

Deveikis

2009

Handbook of Cerebrovascular Disease and Neurointerventional Technique

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Surgical management of aneurysms of the bifurcation of the internal carotid artery

Cited by 34 publications

References 31 publications

Stent placement for the treatment of complex internal carotid bifurcation aneurysms: a review of 16 cases

Stent placement for the treatment of complex internal carotid bifurcation aneurysms: a review of 16 cases

Microsurgical clipping of anterior circle of willis aneurysms: a retrospective study

Intracranial Aneurysms and Subarachnoid Hemorrhage

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