Selective microsurgical treatment of giant intracranial aneurysms

Abstract Giant intracranial aneurysms are defined as greater than 25 mm in diameter. They share the same surgical challenges and strategies as so-called complex aneurysms, sometimes smaller in size but presenting with similar complex anatomy. The surgical difficulties arise from the size of the sack...

Full description

Saved in:
Bibliographic Details
Published in:Neuro-chirurgie 2016-02, Vol.62 (1), p.30-37
Main Authors: Lejeune, J.-P, Thines, L, Proust, F, Riegel, B, Koussa, M, Decoene, C
Format: Article
Language:English
Subjects:
Anévrismes complexes
Anévrismes géants
Cerebral Angiography - methods
Complex aneurysms
Giant aneurysms
Humans
Intracranial Aneurysm - diagnosis
Intracranial Aneurysm - surgery
Microsurgery
Microsurgery - methods
Neurosurgery
Patient Selection
Surgery
Tomography, X-Ray Computed - methods
Traitement microchirurgical
Treatment Outcome
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Giant intracranial aneurysms are defined as greater than 25 mm in diameter. They share the same surgical challenges and strategies as so-called complex aneurysms, sometimes smaller in size but presenting with similar complex anatomy. The surgical difficulties arise from the size of the sack, the presence of intraluminal thrombus, the thickness of the arterial wall, and the complexity of arterial branching on the neck. Preoperative imaging gathers complementary information from magnetic resonance imaging, computed tomographic angiography, and rotational catheter-based angiography with three-dimensional reconstruction including balloon-test occlusion. The therapeutic decision-making needs a multidisciplinary approach including endovascular, neurosurgical and anesthesiological expertises. The microsurgical treatment needs a step-by-step preoperative planning with anticipation of possible pitfalls and alternative strategies. Classical principles of aneurysm surgery have to be tailored to face the difficulties arising from the size of the sack and from the arterial wall calcifications.
ISSN:0028-3770
1773-0619
DOI:10.1016/j.neuchi.2015.12.001