Unruptured Supraclinoid Internal Carotid Artery Aneurysm Surgery : Superciliary Keyhole Approach versus Pterional Approach.
10.3340/jkns.2012.52.4.306
- Author:
Donguk SHIN
1
;
Jaechan PARK
Author Information
1. Department of Neurosurgery, Cardiocerebrovascular Center, Kyungpook National University, Daegu, Korea. jparkmd@hotmail.com
- Publication Type:Original Article
- Keywords:
Cerebral aneurysm;
Internal carotid artery;
Minimal surgical procedure;
Treatment outcome
- MeSH:
Aneurysm;
Blood Transfusion;
Carotid Artery, Internal;
Humans;
Intracranial Aneurysm;
Surgical Procedures, Minimally Invasive;
Treatment Outcome
- From:Journal of Korean Neurosurgical Society
2012;52(4):306-311
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: A superciliary keyhole approach is an attractive, minimally invasive surgical technique, yet the procedure is limited due to a small cranial opening. Nonetheless, an unruptured supraclinoid internal carotid artery (ICA) aneurysm can be an optimal surgical target of a superciliary approach as it is located in the center of the surgical view and field. Therefore, this study evaluated the feasibility and surgical outcomes of a superciliary keyhole approach for unruptured ICA aneurysms. METHODS: The authors report on a consecutive series of patients who underwent a superciliary approach for clipping unruptured ICA aneurysms between January 2007 and February 2012. The data were compared with a historical control group who underwent a pterional approach between January 2003 and December 2006. RESULTS: In the superciliary group, a total of 71 aneurysms were successfully clipped without a residual sac in 70 patients with a mean age of 57 years (range, 37-75 years). The maximum diameter of the aneurysms ranged from 4 mm to 14 mm (mean+/-standard deviation, 6.6+/-2.3 mm). No direct mortality or permanent morbidity was related to the surgery. The superciliary approach demonstrated statistically significant advantages over the pterional approach, including a shorter operative duration (mean, 100 min), no intraoperative blood transfusions, and no postoperative epidural hemorrhages. CONCLUSION: A superciliary keyhole approach provides a sufficient surgical corridor to clip most unruptured supraclinoid ICA aneurysms in a minimally invasive manner.
