Selective clipping of giant anterior ...
Document type :
Article dans une revue scientifique: Article original
PMID :
Permalink :
Title :
Selective clipping of giant anterior communicating artery aneurysms remains a reliable therapeutic option.
Author(s) :
Aboukais, Rabih [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Thérapies Assistées par Lasers et Immunothérapies pour l'Oncologie - U 1189 [OncoThAI]
Karnoub, Mélodie-Anne [Auteur]
Protéomique, Réponse Inflammatoire, Spectrométrie de Masse (PRISM) - U1192
Haettel, P. [Auteur]
Département de Neurochirurgie[Lille]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Bretzner, Martin [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Lille Neurosciences & Cognition - U 1172 [LilNCog]
Bourgeois, Philippe [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Lejeune, Jean-Paul [Auteur]
Thérapies Lasers Assistées par l'Image pour l'Oncologie (ONCO-THAI) - U1189
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Thérapies Assistées par Lasers et Immunothérapies pour l'Oncologie - U 1189 [OncoThAI]
Karnoub, Mélodie-Anne [Auteur]
Protéomique, Réponse Inflammatoire, Spectrométrie de Masse (PRISM) - U1192
Haettel, P. [Auteur]
Département de Neurochirurgie[Lille]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Bretzner, Martin [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Lille Neurosciences & Cognition - U 1172 [LilNCog]
Bourgeois, Philippe [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Lejeune, Jean-Paul [Auteur]
Thérapies Lasers Assistées par l'Image pour l'Oncologie (ONCO-THAI) - U1189
Journal title :
Clinical Neurology and Neurosurgery
Abbreviated title :
Clin Neurol Neurosurg
Volume number :
232
Pages :
107868
Publication date :
2023-07-09
ISSN :
1872-6968
English keyword(s) :
Anterior communicating artery
Giant aneurysm
Clipping
Pterional approach
Giant aneurysm
Clipping
Pterional approach
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
Background
Giant 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 >Background Giant 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. Methods Among 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. Results In 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. Conclusion Selective 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 >
Show more >Background Giant 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. Methods Among 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. Results In 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. Conclusion Selective 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 >
Peer reviewed article :
Oui
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
Université de Lille
Inserm
CHU Lille
Inserm
CHU Lille
Collections :
Submission date :
2023-12-13T03:42:48Z
2024-01-29T15:35:58Z
2024-01-29T15:35:58Z