Subtemporal approach for posterior communicating artery aneurysms
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View abstract on PubMed
Summary
This summary is machine-generated.The subtemporal approach offers a safe and effective alternative for clipping posterior communicating artery (PCoA) aneurysms, especially those with posterior projection or true PCoA aneurysms. This method provides better visualization and good clinical outcomes in experienced hands.
Area Of Science
- Neurosurgery
- Vascular Neurology
- Surgical Techniques
Background
- Microsurgical clipping of posterior communicating artery (PCoA) aneurysms with posterior projection or true PCoA aneurysms can be challenging via the pterional approach due to visualization difficulties.
- Direct visualization of the aneurysmal neck and related perforating arteries is often complicated.
Purpose Of The Study
- To evaluate the efficacy, safety, and feasibility of the subtemporal approach for microsurgical clipping of PCoA aneurysms.
- To assess clinical outcomes and identify indications for this surgical technique.
Main Methods
- Retrospective collection of clinical and angiographic data for PCoA aneurysms from January 2022 to January 2023.
- Inclusion of 10 consecutive patients treated with microsurgical clipping via the subtemporal approach at a single institution.
- Analysis of surgical experience and clinical outcomes.
Main Results
- Complete clipping of all aneurysms was achieved via the subtemporal approach.
- Procedure-related complications included oculomotor nerve palsy (10%), contralateral cerebral infarction (10%), and intraoperative rupture (30%).
- Good functional outcomes were achieved in 90% of patients, with one patient (10%) experiencing a poor outcome.
Conclusions
- The subtemporal approach is a relatively safe and effective alternative for managing refractory PCoA aneurysms, particularly those with posterior projection or true PCoA aneurysms.
- This approach offers improved visualization of the aneurysm neck, PCoA, and perforating vessels.
- Successful outcomes depend on appropriate patient selection, understanding of indications, anatomical knowledge, and meticulous preoperative planning.
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