Loading…
Selective clipping of giant anterior communicating artery aneurysms remains a reliable therapeutic option
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. Among all operated patients from an intracrani...
Saved in:
| Published in: | Clinical neurology and neurosurgery 2023-09, Vol.232, p.107868, Article 107868 |
|---|---|
| Main Authors: | , , , , , |
| Format: | Article |
| Language: | English |
| Subjects: | |
| Citations: | Items that this one cites |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| cited_by | |
|---|---|
| cites | cdi_FETCH-LOGICAL-c425t-91ff84f828a44b66f085d58427151e0336fa733342367da44165b768ce3db073 |
| container_end_page | |
| container_issue | |
| container_start_page | 107868 |
| container_title | Clinical neurology and neurosurgery |
| container_volume | 232 |
| creator | Aboukais, Rabih Karnoub, Mélodie-Anne Haettel, Pierre Bretzner, Martin Bourgeois, Philippe Lejeune, Jean-Paul |
| description | 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.
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 ( |
| doi_str_mv | 10.1016/j.clineuro.2023.107868 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_hal_p</sourceid><recordid>TN_cdi_hal_primary_oai_HAL_hal_04424827v1</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0303846723002846</els_id><sourcerecordid>2863282853</sourcerecordid><originalsourceid>FETCH-LOGICAL-c425t-91ff84f828a44b66f085d58427151e0336fa733342367da44165b768ce3db073</originalsourceid><addsrcrecordid>eNqFkU1r3DAQhkVoSTZp_0Iw9NIcvNWXJe2tITRJYaGH5i5keZxosS1Xshf233eMkxx66UFIzDx65-Ml5JrRLaNMfTtsfRcGmFPccsoFBrVR5oxsmNG8VDtlPpANFVSURip9QS5zPlBKhVDmnFwILTnbCbYh4Td04KdwhAIFxzEMz0Vsi-fghqnAAynEVPjY9_MQvJuWvEsYPmEWy59yn4sEvQtDLhy-uuDqDorpBZIbYZ6CL-I4hTh8Ih9b12X4_Hpfkaf7H093j-X-18PPu9t96SWvpnLH2tbI1nDjpKyVaqmpmspIrlnFYBmgdVoIIblQukGGqarWyngQTU21uCI3q-yL6-yYQu_SyUYX7OPt3i4xKiWXhusjQ_bryo4p_pkhT7YP2UPX4WhxzpYbUXGDa1tkv_yDHuKcBhwEKSU49lsJpNRK-RRzTtC-d8CoXXyzB_vmm118s6tv-PH6VX6ue2jev70ZhcD3FQBc3TFAstkHGDw0IaF_tonhfzX-AhpXrCk</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2863282853</pqid></control><display><type>article</type><title>Selective clipping of giant anterior communicating artery aneurysms remains a reliable therapeutic option</title><source>ScienceDirect Journals</source><creator>Aboukais, Rabih ; Karnoub, Mélodie-Anne ; Haettel, Pierre ; Bretzner, Martin ; Bourgeois, Philippe ; Lejeune, Jean-Paul</creator><creatorcontrib>Aboukais, Rabih ; Karnoub, Mélodie-Anne ; Haettel, Pierre ; Bretzner, Martin ; Bourgeois, Philippe ; Lejeune, Jean-Paul</creatorcontrib><description>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.
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.
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.
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.
•Giant anterior communicating artery aneurysm represent a significant surgical challenge.•A selective exclusion by neck clipping is possible using a large fronto-pterional approach.•A partial pars orbitalis resection is sometimes required to better expose aneurysmal neck, especially in emergency situation.•The functional outcome was good in the 2 of 3 patients of our series.</description><identifier>ISSN: 0303-8467</identifier><identifier>ISSN: 1872-6968</identifier><identifier>EISSN: 1872-6968</identifier><identifier>DOI: 10.1016/j.clineuro.2023.107868</identifier><identifier>PMID: 37421931</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Aneurysm ; Aneurysms ; Anterior communicating artery ; Blood clots ; Clipping ; Computed tomography ; Edema ; Frontal gyrus ; Giant aneurysm ; Hematoma ; Hemorrhage ; Hydrocephalus ; Hypertension ; Ischemia ; Life Sciences ; Medical imaging ; Neurology ; Patients ; Pterional approach ; Visual acuity</subject><ispartof>Clinical neurology and neurosurgery, 2023-09, Vol.232, p.107868, Article 107868</ispartof><rights>2023 Elsevier B.V.</rights><rights>Copyright © 2023 Elsevier B.V. All rights reserved.</rights><rights>2023. Elsevier B.V.</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c425t-91ff84f828a44b66f085d58427151e0336fa733342367da44165b768ce3db073</cites><orcidid>0000-0002-7594-4159 ; 0000-0002-5090-6252</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37421931$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.univ-lille.fr/hal-04424827$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Aboukais, Rabih</creatorcontrib><creatorcontrib>Karnoub, Mélodie-Anne</creatorcontrib><creatorcontrib>Haettel, Pierre</creatorcontrib><creatorcontrib>Bretzner, Martin</creatorcontrib><creatorcontrib>Bourgeois, Philippe</creatorcontrib><creatorcontrib>Lejeune, Jean-Paul</creatorcontrib><title>Selective clipping of giant anterior communicating artery aneurysms remains a reliable therapeutic option</title><title>Clinical neurology and neurosurgery</title><addtitle>Clin Neurol Neurosurg</addtitle><description>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.
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.
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.
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.
•Giant anterior communicating artery aneurysm represent a significant surgical challenge.•A selective exclusion by neck clipping is possible using a large fronto-pterional approach.•A partial pars orbitalis resection is sometimes required to better expose aneurysmal neck, especially in emergency situation.•The functional outcome was good in the 2 of 3 patients of our series.</description><subject>Aneurysm</subject><subject>Aneurysms</subject><subject>Anterior communicating artery</subject><subject>Blood clots</subject><subject>Clipping</subject><subject>Computed tomography</subject><subject>Edema</subject><subject>Frontal gyrus</subject><subject>Giant aneurysm</subject><subject>Hematoma</subject><subject>Hemorrhage</subject><subject>Hydrocephalus</subject><subject>Hypertension</subject><subject>Ischemia</subject><subject>Life Sciences</subject><subject>Medical imaging</subject><subject>Neurology</subject><subject>Patients</subject><subject>Pterional approach</subject><subject>Visual acuity</subject><issn>0303-8467</issn><issn>1872-6968</issn><issn>1872-6968</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNqFkU1r3DAQhkVoSTZp_0Iw9NIcvNWXJe2tITRJYaGH5i5keZxosS1Xshf233eMkxx66UFIzDx65-Ml5JrRLaNMfTtsfRcGmFPccsoFBrVR5oxsmNG8VDtlPpANFVSURip9QS5zPlBKhVDmnFwILTnbCbYh4Td04KdwhAIFxzEMz0Vsi-fghqnAAynEVPjY9_MQvJuWvEsYPmEWy59yn4sEvQtDLhy-uuDqDorpBZIbYZ6CL-I4hTh8Ih9b12X4_Hpfkaf7H093j-X-18PPu9t96SWvpnLH2tbI1nDjpKyVaqmpmspIrlnFYBmgdVoIIblQukGGqarWyngQTU21uCI3q-yL6-yYQu_SyUYX7OPt3i4xKiWXhusjQ_bryo4p_pkhT7YP2UPX4WhxzpYbUXGDa1tkv_yDHuKcBhwEKSU49lsJpNRK-RRzTtC-d8CoXXyzB_vmm118s6tv-PH6VX6ue2jev70ZhcD3FQBc3TFAstkHGDw0IaF_tonhfzX-AhpXrCk</recordid><startdate>20230901</startdate><enddate>20230901</enddate><creator>Aboukais, Rabih</creator><creator>Karnoub, Mélodie-Anne</creator><creator>Haettel, Pierre</creator><creator>Bretzner, Martin</creator><creator>Bourgeois, Philippe</creator><creator>Lejeune, Jean-Paul</creator><general>Elsevier B.V</general><general>Elsevier Limited</general><general>Elsevier</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>1XC</scope><orcidid>https://orcid.org/0000-0002-7594-4159</orcidid><orcidid>https://orcid.org/0000-0002-5090-6252</orcidid></search><sort><creationdate>20230901</creationdate><title>Selective clipping of giant anterior communicating artery aneurysms remains a reliable therapeutic option</title><author>Aboukais, Rabih ; Karnoub, Mélodie-Anne ; Haettel, Pierre ; Bretzner, Martin ; Bourgeois, Philippe ; Lejeune, Jean-Paul</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c425t-91ff84f828a44b66f085d58427151e0336fa733342367da44165b768ce3db073</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Aneurysm</topic><topic>Aneurysms</topic><topic>Anterior communicating artery</topic><topic>Blood clots</topic><topic>Clipping</topic><topic>Computed tomography</topic><topic>Edema</topic><topic>Frontal gyrus</topic><topic>Giant aneurysm</topic><topic>Hematoma</topic><topic>Hemorrhage</topic><topic>Hydrocephalus</topic><topic>Hypertension</topic><topic>Ischemia</topic><topic>Life Sciences</topic><topic>Medical imaging</topic><topic>Neurology</topic><topic>Patients</topic><topic>Pterional approach</topic><topic>Visual acuity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Aboukais, Rabih</creatorcontrib><creatorcontrib>Karnoub, Mélodie-Anne</creatorcontrib><creatorcontrib>Haettel, Pierre</creatorcontrib><creatorcontrib>Bretzner, Martin</creatorcontrib><creatorcontrib>Bourgeois, Philippe</creatorcontrib><creatorcontrib>Lejeune, Jean-Paul</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><jtitle>Clinical neurology and neurosurgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Aboukais, Rabih</au><au>Karnoub, Mélodie-Anne</au><au>Haettel, Pierre</au><au>Bretzner, Martin</au><au>Bourgeois, Philippe</au><au>Lejeune, Jean-Paul</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Selective clipping of giant anterior communicating artery aneurysms remains a reliable therapeutic option</atitle><jtitle>Clinical neurology and neurosurgery</jtitle><addtitle>Clin Neurol Neurosurg</addtitle><date>2023-09-01</date><risdate>2023</risdate><volume>232</volume><spage>107868</spage><pages>107868-</pages><artnum>107868</artnum><issn>0303-8467</issn><issn>1872-6968</issn><eissn>1872-6968</eissn><abstract>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.
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.
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.
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.
•Giant anterior communicating artery aneurysm represent a significant surgical challenge.•A selective exclusion by neck clipping is possible using a large fronto-pterional approach.•A partial pars orbitalis resection is sometimes required to better expose aneurysmal neck, especially in emergency situation.•The functional outcome was good in the 2 of 3 patients of our series.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>37421931</pmid><doi>10.1016/j.clineuro.2023.107868</doi><orcidid>https://orcid.org/0000-0002-7594-4159</orcidid><orcidid>https://orcid.org/0000-0002-5090-6252</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0303-8467 |
| ispartof | Clinical neurology and neurosurgery, 2023-09, Vol.232, p.107868, Article 107868 |
| issn | 0303-8467 1872-6968 1872-6968 |
| language | eng |
| recordid | cdi_hal_primary_oai_HAL_hal_04424827v1 |
| source | ScienceDirect Journals |
| subjects | Aneurysm Aneurysms Anterior communicating artery Blood clots Clipping Computed tomography Edema Frontal gyrus Giant aneurysm Hematoma Hemorrhage Hydrocephalus Hypertension Ischemia Life Sciences Medical imaging Neurology Patients Pterional approach Visual acuity |
| title | Selective clipping of giant anterior communicating artery aneurysms remains a reliable therapeutic option |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-08T13%3A21%3A32IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_hal_p&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Selective%20clipping%20of%20giant%20anterior%20communicating%20artery%20aneurysms%20remains%20a%20reliable%20therapeutic%20option&rft.jtitle=Clinical%20neurology%20and%20neurosurgery&rft.au=Aboukais,%20Rabih&rft.date=2023-09-01&rft.volume=232&rft.spage=107868&rft.pages=107868-&rft.artnum=107868&rft.issn=0303-8467&rft.eissn=1872-6968&rft_id=info:doi/10.1016/j.clineuro.2023.107868&rft_dat=%3Cproquest_hal_p%3E2863282853%3C/proquest_hal_p%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c425t-91ff84f828a44b66f085d58427151e0336fa733342367da44165b768ce3db073%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2863282853&rft_id=info:pmid/37421931&rfr_iscdi=true |