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11:58
Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
Published on: August 11, 2015
Endovascular surgery for very small ruptured intracranial aneurysms. Technical note
Sachio Suzuki1, Akira Kurata, Taketomo Ohmomo
1Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan. ssachio@med.kitasato-u.ac.jp
Journal of Neurosurgery
|November 24, 2006
Summary
Endovascular surgery effectively treats very small ruptured aneurysms (< 3 mm) when specific criteria are met. This minimally invasive approach achieved complete obliteration with no immediate complications in a recent study.
Area of Science:
- Neurosurgery
- Interventional Radiology
- Vascular Surgery
Background:
- Endovascular surgery for very small aneurysms (< 3 mm) is debated due to technical challenges and risks.
- This study evaluates endovascular treatment outcomes for these specific lesions.
Observation:
- Twenty-one patients with small ruptured aneurysms (fundus/neck ratio > 1.5) were treated.
- Aneurysms were located in the internal carotid, anterior communicating, middle cerebral, and vertebrobasilar arteries.
- Guglielmi detachable coils were used with a target volume embolization ratio of 30-40%.
Findings:
- All aneurysms achieved complete obliteration via endovascular coiling, confirmed by angiography.
- No procedure-related complications occurred during treatment.
- Only one patient required re-treatment for aneurysm regrowth during follow-up.
Implications:
- Careful patient and coil selection, alongside advanced techniques, enables successful endovascular treatment of small aneurysms.
- This approach offers a viable option for managing challenging small cerebrovascular lesions.
- Good to moderate outcomes were achieved in the majority of treated patients.
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