One-stage operation for bilateral posterior communicating artery aneurysms via unilateral pterional approach: An efficacy analysis
10.3969/j.issn.1672-5921.2011.11.007
- Author:
Qing-Shan DENG
1
Author Information
1. Department of Neurosurgery
- Publication Type:Journal Article
- Keywords:
Intracranial aneurysms;
Microsurgery;
One-stage operation;
Posterior communicating aneurysms;
Pterional approach
- From:
Chinese Journal of Cerebrovascular Diseases
2011;8(11):592-595
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the feasibility and operative effect of the one-stage microsurgery for clipping of bilateral posterior communicating artery aneurysms (BpcoAA). Methods: The clinical data of 28 patients with BpcoAA were analyzed retrospectively. All patients underwent craniotomy and microsurgical clipping of BPcoAA via unilateral pterional approach. The patients were followed up for 6 months to 3 years after microsurgery. The head 3 D-CTA of the patients and their general conditions were reexamined. The Glasgow outcome scale (COS) scores were used to assess the prognosis. Results: Circled digit oneGood preoperative 3D-CTA showed 28 cases with 56 aneurysms, the aneurysms were clipped completely in 24 cases, the contralateral aneurysms were not clipped completely in 3 cases, the aneurysm was not clipped completely on the approach side in 1 case, and none of the patients died. The aneurysms ruptured in 8 cases on the approach sides during the microsurgery. Circled digit twoAfter microsurgery, 7 cases had hydrocephalus, and 5 had vasospasm on the approach sides and 3 on the contralateral sides, 3 suffered pulmonary infection, and 2 had oculomotor nerve injury on the contralateral sides. Circled digit threeThe mean follow-up time of the patients was 1.7 years. The GOS scores: 5 points in 10 cases, 4 points in 7 cases, 3 points in 9 cases, and 2 points in 2 cases. There were no aneurysm recurrence and new aneurysm formation. The patients whose aneurysms were not clipped completely had no recurrence of bleeding. Conclusion: According to 3D-CTA examination, using unilateral pterional approach, aiming at the location of the optic chiasm and the contralateral aneurysm pointing, the one-stage microsurgery for clipping of BpcoAA is safe and feasible.
