ISSN: 1859 - 2872
The initial results of microsurgery of ruptured aneurysms of intracranial part of internal carotid artery via keyhole approaches
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Abstract
Summary
Objective: To evaluate the results of microsurgery of ruptured aneurysms of intracranial part of internal carotid artery via keyhole approaches. Subject and method: This prospective study included 72 patients who were brought to Bach Mai Hospital for ruptured aneurysms of intracranial part of internal carotid artery, between September 2015 and September 2018. Result: the female/male ratio was 35/37, and the mean age was 55.98 ± 8.96 years. According to WFNS grading system, 90.28% patients were in clinical grade 1 and 2, 9.72% in grade 3; 8.33% hemorrhage in grade 1, 19.44% in grade 2, and 72.22% in grade 3 (Fisher scale). 48.61% aneurysms located on the anterior communicating artery and 16.67% on the middle cerebral artery, 29.17% on the posterior communicating artery, 4.17% on the anterior choroidal artery and 1.39% on the carotid terminus (bifurcation). During operation, the rate of intraoperative rupture was 8.33%. Post-operative complications were paralysis (4.17%) and cerebrospinal fluid leakage (2.78%). On the postoperative angiography, 2.78% patients with remnant aneurysms, and 1.39% with arterial occlusions. The good clinical outcome was 93.06%. Conclusion: These keyhole approaches seems to be safe and bring good results in patients with ruptured aneurysms of cerebral part of the internal carotid artery.
Keywords: Cerebral aneurysms, minimally invasive surgery, keyhole operations.
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References
2. Phạm Quỳnh Trang (2014) Kết quả điều trị vi phẫu thuật túi phình động mạch thông trước bằng đường mở sọ lỗ khóa trên ổ mắt. Luận văn tốt nghiệp Thạc sĩ Y học, Trường Đại học Y Hà Nội.
3. Caplan JM, Papadimitriou K, Yang W et al (2014) The minipterional craniotomy for anterior circulation aneurysms: initial experience with 72 patients. Neurosurgery. 10(2): 200-206.
4. Chalouhi N, Jabbour P, Ibrahim I et al (2013) Surgical treatment of ruptured anterior circulation aneurysms: Comparison of pterional and supraorbital keyhole approaches. Neurosurgery. 72(3): 437-441.
5. Chen L, Tian X, Zhang J (2009) Is eyebrow approach suitable for ruptured anterior circulation aneurysms on early stage: A prospective study at a single institude. Acta Neurochirurgica 151: 781-784.
6. Fischer G, Stadie A, Reisch R et al (2011) The keyhole concept in aneurysm surgery: Results of the past 20 years. Neurosurgery 68(1): 41-51.
7. Lan Q, Gong Z, Kang D et al (2006) Microsurgical experience with keyhole operations on intracranial aneurysms. Surg Neurol 66(1): 2-9
8. Mitchell P, Vindlacheruvu R, Mahmood K (2005) Supraorbital eyebrow minicraniotomy for anterior circulation aneurysms. Surgical Neurology 63: 47-51.
9. Yamahata H, Tokimura H, Tajitsu K et al (2014) Efficacy and safety of the pterional keyhole approach for the treatment of anterior circulation aneurysms. Neurosurg Rev 37: 629-636.
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