Neuronavigation-assisted microsurgical operation via keyhole approaches for distal intracranial artery aneurysms
10.3760/cma.j.issn.1001-2036.2019.06.009
- VernacularTitle: 神经导航辅助锁孔入路显微手术治疗颅内动脉远端动脉瘤
- Author:
Chungang DAI
1
;
Ailin CHEN
;
Chao SUN
;
Tao WU
;
Qing ZHU
;
Qing LAN
Author Information
1. Department of Neurosurgery, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province 215004, China
- Publication Type:Clinical Trail
- Keywords:
Intracranial aneurysm;
Surgical approach;
Keyhole;
Neuronavigation;
Microsurgical operation
- From:
Chinese Journal of Microsurgery
2019;42(6):553-556
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the value of neuronavigation system in the keyhole microsurgical operation for distal intracranial artery aneurysms(DIAA).
Methods:The clinical data of 16 cases with DIAA who were treated by via keyhole approaches, from January, 2013 to December, 2018, were analyzed retrospectively. Ten aneurysms located in anterior cerebral artery(ACA), 3 in posterior inferior cerebellum artery(PICA) and 3 in perforator artery(PA). The optimal skin incision and craniotomy were designed with assistence of neuronavigation system preoperatively, and lesions were located precisely under the guidance of neuronavigation system during microsurgery before clipping or resection. Angiography was performed before discharge, and clinic followed-up was conducted monthly till 6 months after surgery.
Results:The systematic error of neuronavigation system ranged from 0.5 mm to 1.0 mm, with an average of 0.6 mm. All 16 aneurysms were explored and managed successfully with the guidance of neuronavigation system without aneurysm premature rupture nor neuronavigation-related complications. Absolute occlusion of all aneurysms was documented angiographically after surgery. Of all cases, 2 experienced shunt procedure due to delayed hydrocephalus. During 6 months follow-up period, all 16 cases recovered well.
Conclusion:Neuronavigation system can precisely locate the deep-seated DIAA, contribute to the preoperative planning of microsurgery via keyhole approaches and avoid evitable injury during excessive manipulation. The noninvasive, rapid and contrast-enhanced CT images of head was an ideal data source for the neuronavigation system.
