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

作者：Shin Donguk; Park Jaechan^*

来源：Journal of Korean Neurosurgical Society, 2012, 52(4): 306-311.

DOI：10.3340/jkns.2012.52.4.306

• Cerebral aneurysm
• Internal carotid artery
• Minimal surgical procedure
• Treatment outcome

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. %26lt;br%26gt;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. %26lt;br%26gt;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 +/- standard deviation, 6.6 +/- 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. %26lt;br%26gt;Conclusion : A superciliary keyhole approach provides a sufficient surgical corridor to clip most unruptured supraclinoid ICA aneurysms in a minimally invasive manner.

• 出版日期2012-10