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Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
Published on: August 11, 2015
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Falxuplication, a Novel Method for Wrap-Clipping a Fusiform Aneurysm: Technical Note.
Martin M Mortazavi1, Tania Hassanzadeh2, Kianoush Khalili1
1National Skull Base Center, Thousand Oaks, California, USA.
World Neurosurgery
|September 24, 2017
Summary
This study introduces using the falx cerebri for wrap-clipping ruptured fusiform anterior cerebral artery aneurysms. This technique offers a safe solution for complex cases not treatable with endovascular methods.
Area of Science:
- Neurosurgery
- Vascular Neurosurgery
- Cerebrovascular Surgery
Background:
- Fusiform intracranial aneurysms, particularly those involving the anterior cerebral artery, present complex surgical challenges.
- Existing wrap-clipping techniques lack literature regarding the use of the falx cerebri.
- A ruptured fusiform pericallosal artery aneurysm, adherent to the falx cerebri and unsuitable for endovascular treatment, is presented.
Observation:
- A novel surgical approach involved dissecting a portion of the inferior falx cerebri.
- This falx segment was wrapped around the fusiform aneurysm while maintaining its attachment.
- A fenestrated clip was used for stabilization, with a slightly longer falx segment to prevent stenosis.
Findings:
- The patient remained neurologically intact post-procedure.
- Neurological status was maintained at a 12-month follow-up.
- The technique successfully addressed the ruptured fusiform aneurysm.
Implications:
- The inferior falx cerebri is a viable option for wrap-clipping ruptured fusiform anterior cerebral artery aneurysms.
- This method provides a safe and effective alternative for complex cerebrovascular cases.
- Wrap-clipping with the falx cerebri can be performed without compromising arterial flow.
