Minimally invasive microsurgery for anterior communicating artery aneurism: lateral supra-orbitary approach plus intra-operatory fluorescein angiography
DOI:
https://doi.org/10.20453/rmh.v33i1.4169Keywords:
Aneurysm, microsurgery, fluoresceinAbstract
Anterior communicating artery aneurisms (ACAA) are complex and require endovascular or microsurgery approaches. The use of minimally invasive microsurgery techniques is evolving. We present the case of a 34-year- old patient with a broad neck, non-broken, ACAA with a Glasgow coma scale of 15 points. A lateral supra-orbitary approach with total clipping of the ACAA using intra-operatory fluorescein angiography was performed. The objective was accomplished successfully and safe, optimizing both intra-operative and hospitalization times, thus, maximizing patient comfort, esthetic and prompt return to normal duties.
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Brock M, Dietz H. The small frontolateral approach for the microsurgical treatment of intracranial aneurysms. Neurochirurgia (Stuttg). 1978; 21(6):185-91. doi: 10.1055/s-0028-1090343.
Pietrantonio A, Trungu S, Raco A. Clinical and neuropsychological outcome after microsurgical and endovascular treatment of ruptured and unruptured anterior communicating artery aneurysms: A single-enter experience. Acta Neurochir Suppl. 2017; 124:173-177.
Wong J, Tymianski R. Minimally invasive microsurgery for cerebral aneurysm. 2015. Stroke. 2015;46(9):2699-706. doi: 10.1161/STROKEAHA.115.008221
Cha KC, Hong SC, Kim JS. Comparison between lateral supraorbital approach and pterional approach in the surgical treatment of unruptured intracranial aneurysms. J Korean Neurosurg Soc. 2012; 51(6):334-337.
Elsharkawy A, Abdelhameed A. The lateral supraorbital approach, doable and cosmetic access to anterior skull base. 2020. Egypt J Neurosurg. 2020; 35(15). DOI: 10.1186/s41984-020-00086-7
Fukushima T. Nomaka Y. Manual of Skull base Dissection. Third edition. 2011; 420-421.
Hernesniemi J, Ishii K, Niemelä M, et al. Lateral supraorbital approach as an alternative to the classical pterional approach. Acta Neurochir Suppl. 2005; 94:17-21
Mori K, Yamamoto T, Nakao Y, et al. Lateral supraorbital keyhole approach to clip unruptured anterior communicating artery aneurysms. Minim Invasive Neurosurg. 2008;51(5):292-297.
Zhao X, Belykh E, Cavallo C, et al. Application of fluorescein fluorescence in vascular neurosurgery. Front Surg. 2019; 6:52.
Fukushima T, Nonaka Y. Fukushima manual of skull base dissection. Raleigh, NC: AF-Neuro Video; 1996.p. 426-427.
Świątnicki W, Komuński P. Intraoperative fluorescein videoangiography in cerebral aneurysm surgery - a preliminary study.Pol Merkur Lekarski. 2019; 47(281):183-186.
Suzuki K, Kodama N, Sasaki T, et al. Confirmation of blood flow in perforating arteries using fluorescein cerebral angiography during aneurysm surgery. J Neurosurg. 2007; 107(1):68-73.
Chalouhi N, Jabbour P, Ibrahim I, et al. Surgical treatment of ruptured anterior circulation aneurysms: comparison of pterional and supraorbital keyhole approaches. Neurosurgery. 2013; 72(3):437-41.
Park J. Supraorbital keyhole approach for intracranial aneurysms: Transitioning from concerns to confidence. J Korean Neurosurg Soc. 2020; 63(1):4-13.
Salma A, Alkandari A, Sammet S, Ammirati M. Lateral supraorbital approach vs pterional approach: an anatomic qualitative and quantitative evaluation. Neurosurgery. 2011; 68(2 Suppl):364-72.
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