Side selection of the pterional approach for anterosuperior-pointing anterior communicating artery aneu-rysms
10.3969/j.issn.1002-0152.2015.09.009
- VernacularTitle:前上指向前交通动脉瘤采用翼点入路的侧别选择
- Author:
Long ZHANG
;
Baoguo LIU
;
Songtao QI
;
Guozhong ZHANG
;
Weiguang LI
;
Wenfeng FENG
- Publication Type:Journal Article
- Keywords:
Anterior communicating artery;
Aneurysms;
Projection;
A2 plane;
Clipping
- From:
Chinese Journal of Nervous and Mental Diseases
2015;(9):558-563
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the difficulty, safety and clinical efficacy of the pterional approach from the side of open A2 plane vs the approach from the side of closed A2 plane for anterosuperior-pointing anterior communicat?ing artery aneurysms (ACoAA). Methods Forty-two patients with anterosuperior-pointing ACoAA treated by microsurgi?cal clipping were divided into two groups of the approach from the side of open A2 plane (n=22) and the approach from the side of closed A2 plane (n=20). Primary objective endpoints were rates of gyrus rectus aspiration, displacement of the ipsilateral A2 and surgical-related complications, clipping results, incidence of cognitive function impairment and Glasgow Outcome Scale (GOS) at 6 months after treatment. Results The incidence of gyrus rectus aspiration and dis?placement of the ipsilateral A2, cognitive impairment at 6 months after treatment and the surgical-related complications was also significant lower in the approach from the side of open A2 plane than in the approach from the side of closed A2 plane [4(18.2%) cases vs. 11(55.0%) cases, χ2=6.185, P<0.05;4(18.2%) cases vs. 10(50.0%) cases, χ2=4.773, P<0.05;1 (4.5%) case vs. 7(35.0%) cases, χ2=4.481 P<0.05]. There were no significant differences in postoperative clipping results and GOS at 6 months after treatment between two approaches (P>0.05). Conclusions The pterional approach from the side of open A2 plane in patients with anterosuperior-pointing ACoAA allows the aneurysmal necks to be secured safely, decreases operation difficulty and prevents surgical-related complications.
