Related Experiment Video
Updated: Mar 17, 2026
11:58
Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
Published on: August 11, 2015
16.6K
Modified Far Lateral Approach for Posterior Circulation Aneurysms: An Institutional Experience
Anil Nanda1, Subhas Konar1, Shyamal C Bir1
1Department of Neurosurgery, Louisiana State University Health Sciences Center Shreveport, Shreveport, Louisiana, USA.
World Neurosurgery
|July 21, 2016
Summary
The modified far lateral approach offers a safe and effective surgical option for brainstem and craniovertebral junction aneurysms. This technique demonstrates low complication rates and good patient outcomes.
Area of Science:
- Neurosurgery
- Vascular Neurosurgery
- Cranial Base Surgery
Background:
- The traditional far lateral approach is used for accessing aneurysms near the brainstem and craniovertebral junction.
- This approach may involve drilling of the condyle, which can increase morbidity.
Purpose of the Study:
- To describe the surgical outcomes and complications of a modified far lateral approach for treating vertebrobasilar, posterior inferior cerebellar artery (PICA), and vertebral artery aneurysms.
- To evaluate the efficacy of this modified technique without condyle drilling.
Main Methods:
- Retrospective review of 26 patients who underwent surgery for vertebrobasilar aneurysms using the modified far lateral approach between 1994 and 2015.
- Analysis of clinical outcomes, including aneurysm clipping success, patient recovery (modified Rankin Scale), and complications.
Main Results:
- The modified far lateral approach was successfully applied to various aneurysms, including 16 PICA, 6 vertebral artery, and 2 basilar artery aneurysms.
- At follow-up (median 67 months), 22 of 25 patients had a good recovery (mRS 1-3).
- Complications included lower cranial nerve palsy (4 patients) and new-onset hydrocephalus (7 patients).
Conclusions:
- The modified far lateral approach, avoiding condyle resection and vertebral artery mobilization, is associated with low procedure-related morbidity.
- This approach provides outcomes comparable to the more extensive traditional far lateral approach for treating these complex aneurysms.
