Open surgery of giant paraclinoid aneurysms improved by intraoperative angiography and endovascular retrograde suction decompression

In three consecutive cases of giant left sided paraclinoid aneurysms we employed an endovascular retrograde suction decompression technique in combination with intra-operative angiography. A double-lumen balloon catheter was placed in the left internal carotid artery by the transfemoral route. After...

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Bibliographic Details
Published in:Acta neurochirurgica 1997-11, Vol.139 (11), p.1026-1032
Main Authors: Fahlbusch, R, Nimsky, C, Huk, W
Format: Article
Language:English
Subjects:
Aneurysm
Angiography
Balloons
Blood
Cardiovascular system
Carotid artery
Catheters
Cerebral Angiography
Decompression
Female
Humans
Intracranial Aneurysm - diagnostic imaging
Intracranial Aneurysm - surgery
Intraoperative Period
Male
Medical Illustration
Medical imaging
Middle Aged
Neoplasia
Neurological diseases
Neurosurgery
Pituitary
Stenosis
Suction - methods
Surgery
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Summary:In three consecutive cases of giant left sided paraclinoid aneurysms we employed an endovascular retrograde suction decompression technique in combination with intra-operative angiography. A double-lumen balloon catheter was placed in the left internal carotid artery by the transfemoral route. After balloon inflation and placement of a temporary clip distal to the aneurysm blood was aspirated and the aneurysm collapsed. Thus further dissection of the aneurysm could easily be achieved and clips could be placed. Afterwards real-time digital subtraction angiography was performed. Intra-operative angiography led to clip repositioning in all cases either due to a clip induced stenosis of the parent vessel, or because of incomplete aneurysm obliteration. Afterwards successful clipping could be confirmed in all cases. Outcome was excellent in one case, good in the other. The third case, extremely complicated by an accompanying craniopharyngioma, showed a satisfactory outcome, but presented new neurological deficits.
ISSN:0001-6268
0942-0940
DOI:10.1007/bf01411555