Title :

Selective clipping of giant anterior communicating artery aneurysms remains a reliable therapeutic option.

Author(s) :

Aboukais, Rabih [Auteur]
Thérapies Assistées par Lasers et Immunothérapies pour l'Oncologie - U 1189 [OncoThAI]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Karnoub, Melodie-Anne [Auteur]
Protéomique, Réponse Inflammatoire, Spectrométrie de Masse (PRISM) - U 1192 [PRISM]
Haettel, P. [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Département de Neurochirurgie[Lille]
Bretzner, Martin [Auteur]
Lille Neurosciences & Cognition - U 1172 [LilNCog]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Bourgeois, Philippe [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Lejeune, Jean-Paul [Auteur]
Thérapies Assistées par Lasers et Immunothérapies pour l'Oncologie - U 1189 [OncoThAI]

Journal title :

Clinical Neurology and Neurosurgery

Pages :

107868

Publisher :

Elsevier

Publication date :

2023-07-09

ISSN :

0303-8467

English keyword(s) :

Anterior communicating artery
Giant aneurysm
Clipping
Pterional approach

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

BackgroundGiant anterior communicating artery (AcomA) aneurysm represent a significant surgical challenge. Our study aimed to discuss the therapeutic strategy in patients with a giant AcomA aneurysm treated by selective ...
Show more >BackgroundGiant anterior communicating artery (AcomA) aneurysm represent a significant surgical challenge. Our study aimed to discuss the therapeutic strategy in patients with a giant AcomA aneurysm treated by selective neck clipping through a pterional approach.MethodsAmong all operated patients from an intracranial aneurysm between January 2015 and January 2022 (n = 726) in our institution, three patients with a giant AcomA aneurysm treated by neck clipping were included. Early (<7days) outcome was noted. Early postoperative CT scan was performed in all patients to detect any complications. Early DSA was also performed to confirm giant AcomA aneurysm exclusion. The mRS score was recorded 3 months after treatment. The mRS≤ 2 was considered as a good functional outcome. Control DSA was performed one year after treatment.ResultsIn the three patients, after a large frontopterional approach, a selective exclusion of their giant AcomA aneurysm was obtained after a partial pars orbitalis of the inferior frontal gyrus resection. Ischemic lesion was noted in 1 patient and chronic hydrocephalus in 2 patients with ruptured aneurysm. The mRS score after 3 months was good in 2 patients. Long term complete occlusion of the aneurysm were noted in the three patients.ConclusionSelective clipping of a giant AcomA aneurysm is a reliable therapeutic option after a careful evaluation of local vascular anatomy. An adequate surgical exposure is frequently obtained through an enlarged pterional approach with an anterior basifrontal lobe resection, especially in an emergency situation and/or in case of high position of anterior communicating artery.Show less >

Language :

Français

Popular science :

Non

Collections :

• Thérapies Lasers Assistées par l'Image pour l'Oncologie (ONCO-THAI) - U1189

Source :

Harvested from HAL