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http://dx.doi.org/10.3340/jkns.2012.52.4.306

Unruptured Supraclinoid Internal Carotid Artery Aneurysm Surgery : Superciliary Keyhole Approach versus Pterional Approach  

Shin, Donguk (Department of Neurosurgery, Cardiocerebrovascular Center, Kyungpook National University)
Park, Jaechan (Department of Neurosurgery, Cardiocerebrovascular Center, Kyungpook National University)
Publication Information
Journal of Korean Neurosurgical Society / v.52, no.4, 2012 , pp. 306-311 More about this Journal
Abstract
Objective : A superciliary keyhole approach is an attractive, minimally invasive surgical technique, yet the procedure is limited due to a small cranial opening. Nonetheless, an unruptured supraclinoid internal carotid artery (ICA) aneurysm can be an optimal surgical target of a superciliary approach as it is located in the center of the surgical view and field. Therefore, this study evaluated the feasibility and surgical outcomes of a superciliary keyhole approach for unruptured ICA aneurysms. Methods : The authors report on a consecutive series of patients who underwent a superciliary approach for clipping unruptured ICA aneurysms between January 2007 and February 2012. The data were compared with a historical control group who underwent a pterional approach between January 2003 and December 2006. Results : In the superciliary group, a total of 71 aneurysms were successfully clipped without a residual sac in 70 patients with a mean age of 57 years (range, 37-75 years). The maximum diameter of the aneurysms ranged from 4 mm to 14 mm (mean${\pm}$standard deviation, $6.6{\pm}2.3$ mm). No direct mortality or permanent morbidity was related to the surgery. The superciliary approach demonstrated statistically significant advantages over the pterional approach, including a shorter operative duration (mean, 100 min), no intraoperative blood transfusions, and no postoperative epidural hemorrhages. Conclusion : A superciliary keyhole approach provides a sufficient surgical corridor to clip most unruptured supraclinoid ICA aneurysms in a minimally invasive manner.
Keywords
Cerebral aneurysm; Internal carotid artery; Minimal surgical procedure; Treatment outcome;
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