Comparison between frontolateral approach and pterional approach in the surgical treatment of paraclinoid aneurysms

• Published in: Journal of clinical neuroscience 2018-06, Vol.52, p.80-87
• Main Authors: Wang, Jiantao, Wu, Jun, Cao, Yong, Kan, Zhisheng, Wang, Shuo
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aneurysm, Ruptured - surgery; Clipping; Craniotomy - adverse effects; Craniotomy - methods; Female; Frontolateral approach; Humans; Intracranial Aneurysm - surgery; Male; Middle Aged; Paraclinoid aneurysms; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Pterional approach
• ISSN: 0967-5868; 1532-2653
• DOI: 10.1016/j.jocn.2018.03.027

•The complex anatomy of paraclinoid aneurysms often makes them difficult to treat.•Our study provides a comparative analysis of the frontolateral and the pterional approach in 176 patients with paraclinoid aneurysms.•The frontolateral approach (FLA) is a simple, reliable, and efficient procedure which allows enough room for intracranial manipulation with maximal protection of the brain and other intracranial structures.•The FLA could be a good alternative to the pterional approach for the treatment of paraclinoid aneurysms. To compare the pterional and frontolateral approach to determine the most effective route for paraclinoid aneurysm surgery. Between June 2010 and December 2015, a total of 176 patients with paraclinoid aneurysm underwent surgical clipping, 96 through the pterional and 80 through the frontolateral approach. We analyzed the two groups and compared demographic, radiologic, and clinical variables including age, sex, aneurysm type,intraoperative rupture rates, operative time,anatomical obstacles,outcome and postoperative complications. The 2 groups were comparable with respect to baseline characteristics. The mean operation time was also signifcantly shorter in frontolateral group than in the pterion group (204.3 min vs. 264.1 min, p