Efficacy and safety of the pterional keyhole approach for the treatment of anterior circulation aneurysms

YamahataH.; TokimuraH.; TajitsuK.TsuchiyaM.TaniguchiA.HirabaruM.TakayamaK.ShinsatoT.HirayamaT.AritaK.

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Efficacy and safety of the pterional keyhole approach for the treatment of anterior circulation aneurysms

机译：Efficacy and safety of the pterional keyhole approach for the treatment of anterior circulation aneurysms

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Keyhole surgery is partly replacing the standard pterional approach in patients undergoing surgery to treat aneurysms of the anterior circulation. We describe the pterional keyhole approach for the clipping of anterior circulation aneurysms and discuss the efficacy and safety of our keyhole craniotomy procedure. We treated 103 patients with 111 intracranial aneurysms by surgical clipping via the pterional keyhole approach and retrospectively compared the characteristics and clinical outcomes of the keyhole procedure and the standard pterional approach. We also compared the surgical results of the keyhole approach when the operator was an experienced neurosurgeon or a less experienced neurosurgeon guided by an experienced colleague. All keyhole operations were carried out successfully without enlargement of the craniotomy or a change to a different approach. The outcomes of the keyhole and the standard pterional approach in patients with subarachnoid hemorrhage were not significantly different. Favorable outcomes were obtained in patients with unruptured aneurysms treated by either experienced or less experienced surgeons. The pterional keyhole approach offers the same surgical possibilities as conventional pterional approaches for the treatment of anterior circulation aneurysms. It is safe and simple and yields favorable outcomes even if the operators are less experienced neurosurgeons. Careful patient selection and sufficient opening of the sylvian fissure are the key points for good outcomes and the prevention of intraoperative complications.

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来源
《Neurosurgical review》 |2014年第4期|629-636|共8页
作者
YamahataH.; TokimuraH.; TajitsuK.TsuchiyaM.TaniguchiA.HirabaruM.TakayamaK.ShinsatoT.HirayamaT.AritaK.;
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作者单位

Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8;

Sendai Neurosurgical ClinicSatsumasendai, Kagoshima, Japan;

Division of Neurosurgery, Sendai Shimin HospitalSatsumasendai, Kagoshima, Japan;

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原文格式 PDF
正文语种英语
中图分类头部及神经外科学;
关键词
Cerebral aneurysm; Clipping; Keyhole craniotomy; Pterional approach; Transsylvian approach;

Efficacy and safety of the pterional keyhole approach for the treatment of anterior circulation aneurysms

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