Clipping of 27 patients with partial complicated posterior communicating artery aneurysms via Dolenc approach: a clinical efficacy analysis
10.3760/cma.j.cn115354-20200830-00697
- VernacularTitle:经Dolenc入路手术夹闭27例部分复杂性后交通动脉瘤的疗效分析
- Author:
Hongwei ZHANG
1
;
Aimin LI
;
Xiguang LIU
;
Dapeng DAI
;
Yuanyuan MING
;
Dong ZHANG
Author Information
1. 徐州医科大学附属连云港医院神经外科 222002
- Keywords:
Dolenc approach;
Partial complicated posterior communicating artery aneurysm;
Anterior clinoid process
- From:
Chinese Journal of Neuromedicine
2020;19(10):995-1000
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical experiences and treatment outcomes of partial complicated posterior communicating artery aneurysms (PCoAs) via Dolenc approach.Methods:The clinical data of 27 patients with partial complicated PCoAs accepted clipping via Dolenc approach in our hospitals from July 2014 to June 2019 were retrospectively reviewed. The clinical efficacies were analyzed and the surgical experiences were summarized in these patients.Results:Among 27 patients with partial complicated PCoAs, 26 accepted clipping successfully via Dolenc approach, and one accepted clipping and wrapping. For clinical ourcomes, 2 out of 3 patients with preoperative oculomotor paralysis got improvement after surgery, and one was without change; in 4 patients with new-onset oculomotor paralysis after surgery, 2 returned to normal after conservative treatment, one got improvement, and one was without change. After surgery, 2 had basal ganglia focal cerebral infarction and one had ventriculoperitoneal shunt due to hydrocephalus. DSA or CTA examination within two weeks after surgery showed all 26 aneurysms were completely clipped and without residual. During the 9-12 months of follow up, Glasgow outcome scale (GOS) showed that 20 patients had GOS 5 scores, 3 had GOS 4 scores, 2 had GOS 3 scores, one had GOS 2 scores, and one died. No patients showed aneurysm recurrent in the imaging examination.Conclusion:Via Dolenc approach, anterior clinoid process and its surrounding bony structures are drilled off via extradural way, and proximal of parent artery is exposed well, therefore, more operation space can be provided to deal with partial complicated PCoAs.
