Clipping Ophthalmic Segment Artery Aneurysms Using a Modified Subdural Dolenc Approach: Classification and Experience...

Area of Science:

• Neurosurgery
• Vascular Surgery
• Ophthalmology

Background:

• Ophthalmic segment artery aneurysms (OSAs) present surgical challenges.
• Improved surgical techniques are crucial for preventing complications.
• Classifying OSAs is essential for effective surgical planning.

Purpose of the Study:

• To evaluate the strategies and outcomes of surgical treatment for OSAs.
• To assess the efficacy of a modified subdural Dolenc approach for OSA clipping.

Main Methods:

• Retrospective analysis of 38 patients with 44 aneurysms, including 40 OSAs.
• Classification of OSAs into types Ia1, Ia2, Ib, IIa, IIb, IIIb, IIIc, and IV.
• Surgical clipping of 39 OSAs using pterional craniotomy and the modified subdural Dolenc approach.
• Evaluation of clinical outcomes using the Glasgow Outcome Scale (GOS).

Main Results:

• Successful clipping of 39 OSAs and wrapping of 1 aneurysm.
• Improvement in visual dysfunction, headache, and dizziness in 18 patients.
• No deaths; one patient experienced new visual impairment.
• High GOS scores at discharge (36/38) and 6 months post-operation (37/38).

Conclusions:

• The modified subdural Dolenc approach (Zheng approach) is a viable surgical option for OSAs.
• This technique may reduce surgical trauma.
• The approach is associated with favorable postoperative outcomes.