Intraoperative endovascular surgery for cerebral aneurysms

Journal of Neurosurgery
G SinsonE S Flamm

Abstract

The application of a number of procedures that can be considered intraoperative endovascular neurosurgery has enhanced our ability to treat cerebral aneurysms from the abluminal surface. This study identifies a role for these techniques in the management of difficult aneurysms. A review of the last 1202 aneurysms undergoing direct clipping by the authors disclosed that these methods were used in 62 cases. Of these aneurysms, 36 arose from the internal carotid artery, 12 from the middle cerebral artery, eight from the vertebrobasilar distribution, and six from the anterior cerebral artery. The indications for applying these methods were large size (12-60 mm), intraluminal thrombus, broad neck, plaque at the neck, the potential compromise of branches at the base of the aneurysm, or a combination of these problems. The most frequently chosen intraoperative technique was suction decompression with direct removal of plaque and thrombus using suction, dissection, and/or ultrasonic aspiration. The application of temporary clips was required in all cases in which the aneurysm was opened before definitive clipping. No special pharmacological cerebral protective regimen was used. In one case in which a greater occlusion time was anticipa...Continue Reading

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Citations

Jan 11, 2007·Journal of Biomedical Optics·Zahid YaqoobChanghuei Yang
Jul 22, 2008·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·A K BhattacharjeeK Ehara
May 2, 2015·World Neurosurgery·Servet InciMerdan Orunoglu
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Dec 5, 2012·Journal of Cerebrovascular and Endovascular Neurosurgery·Sang Woo Ha, Suk Jung Jang
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