Unilateral approach for bilateral clipping of posterior communicating artery aneurysms in a hybrid operating room: A technical note
10.7461/jcen.2023.E2022.12.002
- Author:
Juan Luis GÓMEZ-AMADOR
1
;
Pablo David GUERRERO-SUÁREZ
;
Jaime Jesús MARTÍNEZ-ANDA
;
Jorge Fernando ARAGÓN-ARREOLA
;
Andrea CASTILLO-MATUS
;
Ricardo MARIAN-MAGAÑA
;
Marcos V SANGRADOR-DEITOS
;
Alan HERNÁNDEZ-HERNÁNDEZ
;
Ernesto Javier DELGADO-JURADO
;
Ricardo Santiago VILLAGRANA-SÁNCHEZ
;
Abraham GALLEGOS-PEDRAZA
;
Jorge Luis DIAZ-ESPINOZA
Author Information
1. Department of Neurosurgery, National Institute of Neurology and Neurosurgery, Manuel Velasco Suárez, Mexico City, Mexico
- Publication Type:Technical Note
- From:Journal of Cerebrovascular and Endovascular Neurosurgery
2023;25(4):468-472
- CountryRepublic of Korea
- Language:English
-
Abstract:
Bilateral posterior communicating (pComm) artery aneurysms represent only 2% of mirror intracranial aneurysms. Usually, these are surgically approached through bilateral craniotomies for clipping. We present the case of a 50-year-old female presenting with headache and horizontal diplopia. Neurological examination revealed a left oculomotor palsy, with no other neurological deficits. Imaging studies revealed bilateral aneurysmatic lesions in both internal carotid arteries (ICA). A conventional left pterional approach was planned in order to treat the symptomatic aneurysm, and, if deemed feasible, a contralateral clipping through the same approach. The procedure was performed in a hybrid operating room (HOR), performing an intraoperative digital subtraction angiography (DSA) and roadmapping assistance during dissection and clipping. Transoperatively, a post-fixed optic chiasm was identified, with a wide interoptic space, which allowed us to perform the contralateral clipping through a unilateral approach. This technique for clipping bilateral pComm aneurysms can be performed when the proper anatomical features are met.
