1. Application of micro-mirror in microsurgical clipping to the intracranial aneurysm
Chao ZHAO ; Yugong FENG ; Yunxue YANG ; Yuhai ZHANG ; Qinglei HU ; Tingkai FU ; Ronghua SHI ; Yanping WANG ; Yonglin YANG
Journal of Chinese Physician 2019;21(10):1486-1489,1494
Objective:
To explore the value and disadvantage of micro-mirror in the intracranial aneurysm surgery.
Methods:
Micro-mirror was used to assist microsurgical clipping to 36 intracranial aneurysms in 31 cases, of which 3 were carotid-ophthalmic artery aneurysms, 3 anterior choroidal artery aneurysm, 11 were posterior communicating artery aneurysms, 7 were middle cerebral artery aneurysms, 10 anterior communicating artery or anterior cerebral artery aneurysms, and the others were a posterior cerebral artery aneurysm and a posterior inferior cerebellar artery aneurysm. The micro-mirror was used before and after clipping to observe the anatomic features of necks hidden behind and medial to aneurysms, to visualize surrounding neurovascular structures, and to verify the optimal clipping position. Intraoperative indocyanine green fluorescein angiography confirmed the success of sufficient clipping.
Results:
All aneurysms were clipped successfully. The parent arteries were occluded temporarily in 26 cases, and 9 aneurysms ruptured during the operation. Postoperative follow-up lasted from 2 weeks to 1 year. After operations digital subtraction angiography (DSA) were repeated in 10 cases, computed tomography angiography(CTA) in 21 cases, and no insufficient clipping or occlusion of parent arteries were revealed.
Conclusions
Micro-mirror assisting microsurgical clipping to the intracranial aneurysm is conducive to accurate clipping, and is a convenient and practical operation.