Interhemispheric Approach for ACom Aneurysm

Noda, Kosumo; Tanikawa, Rokuya; Kamiyama, Hiroyasu; Ohta, Nakao; Yabuuchi, Tomonari; Miyata, Shirou; Kosaka, Akira; Tsuboi, Toshiyuki; Tokuda, Sadahisa

doi:10.7887/jcns.21.834

Cited by 5 publications

(4 citation statements)

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“…[ 4 ] For anterior cerebral artery and AcomA aneurysms, this is also possible by using an interhemispheric approach. [ 5 8 ] If clipping is performed through the pterional approach for an anterior communicating aneurysm, it is impossible to achieve closure line obliteration. Closure line obliteration can also sometimes be achieved for IC-PcomA and basilar top aneurysms, and a fenestrated mini-clip is very useful in such narrow conditions with a limited approach angle.…”

Section: Discussionmentioning

confidence: 99%

The efficiency of the new Yasargil titanium fenestrated mini-clips for ideal clipping of a cerebral aneurysm

Ota¹,

Tanikawa²,

Noda³

et al. 2015

Surg Neurol Int

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Background:The fenestrated clip is sometimes useful in limited approach angle and narrow working space. However, before the development of the new Yasargil titanium fenestrated mini-clip, the only variations of fenestrated clips were those of larger sizes. And those larger clips have a problem of the triangle-shaped gap at the proximal end of the blade. The authors describe the efficiency, limitations and surgical technique of using the Yasargil titanium fenestrated mini-clip.Methods:Fifty-nine cases of aneurysms were treated using these mini-clips. Aneurysm location, size and dome neck ratio, mean follow-up period, neck remnant, and recurrence rate were also analyzed. Among these cases, we present eight characteristic cases, including a case with aneurysm recurrence, and we review the problems associated with the triangle-shaped gap at the proximal end of the clip.Results:The average size of the aneurysms was 5.57 mm, and the dome neck ratio was >2.0 in 1.69%, >1.5 in 11.8%, >1.2 in 35.6%, and <1.2 in 50.8% of cases. The mean follow-up period for the 59 cases was 5.5 months (range, 0.5–16 months). Angiographic recurrence of the treated portion occurred in 1 case (1.7%), including an aneurysm in the basilar artery tip aneurysm.Conclusion:The availability of the Yasargil titanium fenestrated mini-clip increases the options for clipping to minimize the remnant of the clipped aneurysm. However, there is still concern over the triangular space at the base of the blade, especially when treating an aneurysm with a thin vessel wall. Therefore, modification of the clipping technique is sometimes needed.

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Section: Discussionmentioning

confidence: 99%

The efficiency of the new Yasargil titanium fenestrated mini-clips for ideal clipping of a cerebral aneurysm

Ota¹,

Tanikawa²,

Noda³

et al. 2015

Surg Neurol Int

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“…The medial-inferior craniotomy margin was the root of the nose. The FS was exposed in most cases (21).…”

Section: Surgical Technique Of Bifrontal Craniotomymentioning

confidence: 99%

“…After complete dural closure, the bone flap was returned to the skull. The periosteum, subcutaneous tissue, and skin were closed in layers (21).…”

Section: Surgical Technique Of Fs Reconstructionmentioning

confidence: 99%

“…B ifrontal craniotomy is effective for the treatment of anterior skull base tumors (5,6,16,18) and anterior cerebral artery aneurysms (1,4,13,18,21,32). However, the frontal sinus (FS) is often opened during this surgery, and various postoperative complications may occur as a result of the open FS, including cerebrospinal fluid (CSF) leakage and infection (e.g., meningitis, brain abscess, subdural abscess, epidural abscess, and subcutaneous or subperiosteal abscess) (5,8,10,17,18,20,22,25,26,32).…”

Section: Introductionmentioning

confidence: 99%

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