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[Surgery for giant intracranial aneurysms using advanced technology].
Takamasa Kayama1, Kaori Sakurada, Rei Kondo
1Department of Neurosurgery, Yamagata University School of Medicine, Japan.
No Shinkei Geka. Neurological Surgery
|May 21, 2003
Summary
Advanced surgical techniques improved outcomes for giant intracranial aneurysms. Intraoperative angiography and neuroendoscopes, combined with balloon occlusion tests, helped prevent complications during clipping procedures.
Area of Science:
- Neurosurgery
- Vascular Surgery
- Interventional Neuroradiology
Background:
- Giant intracranial aneurysms present significant surgical challenges.
- Complications often arise from perforator occlusion or parent artery compromise during clipping.
Purpose of the Study:
- To report the surgical outcomes of giant intracranial aneurysms treated with novel techniques.
- To detail methods developed to prevent intraoperative complications.
Main Methods:
- Eight patients with giant intracranial aneurysms underwent surgery.
- Preoperative 3DCTA, balloon occlusion tests (with SEP monitoring and Xe-SPECT), intraoperative angiography, and neuroendoscopy were utilized.
- Aneurysms were located in the internal carotid artery (ICA) or middle cerebral artery (MCA).
Main Results:
- Complete obliteration of the aneurysm neck was achieved in seven of eight cases.
- Six patients had good recovery, one had moderate disability (hemiparesis), and one died from rebleeding.
- The patient with moderate disability experienced vasospasm; the deceased patient had clip slippage.
Conclusions:
- Improved surgical outcomes for giant aneurysms were achieved.
- The use of temporary clips guided by balloon occlusion tests, alongside intraoperative angiography and neuroendoscopes, proved beneficial.