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.
References
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.
Downloads
Published
How to Cite
Issue
Section
License
Authors assign their rights to the RMH so that may disseminate the article through the means at their disposal. The journal will provide forms of affidavit of authorship and authorization for the publication of the article, which shall be submitted with the manuscript. Authors retain the right to share, copy, distribute, perform and publicly communicate their article, or part of it, mentioning the original publication in the journal.
