Endovascular Treatment of Intracranial Aneurysms: A Minimally Invasive Approach with Advantages for Elderly Patients

Introduction. Elderly patients with primary hyperparathyroidism (pHPT) are often not referred to surgery because of their associated comorbidities that may increase surgical risk. The aim of the study was to review indications and results of minimally invasive approach parathyroidectomy in elderly patients to evaluate its impact on outcome.Materials and Methods. All patients of 70 years of age or older undergoing minimally approach parathyroidectomy at our Department from May 2005 to May 2011 were reviewed. Data collected included patients demographic information, biochemical pathology, time elapsed from pHPT diagnosis to surgical intervention, operative findings, complications, and results of postoperative biochemical studies.Results and Discussion. 37 patients were analysed. The average length of stay was 2.8 days. 11 patients were discharged within 24 hours after their operation. Morbidity included 6 transient symptomatic postoperative hypocalcemias while one patient developed a transient laryngeal nerve palsy. Time elapsed from pHPT diagnosis to first surgical visit evidences that the elderly patients were referred after their disease had progressed.Conclusions. Our data show that minimally invasive approach to parathyroid surgery seems to be safe and curative also in elderly patients with few associated risks because of combination of modern preoperative imaging, advances in surgical technique, and advances in anesthesia care.

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Management of periprosthetic acetabular fractures in elderly patients—a minimally invasive approach

International Orthopaedics ◽

10.1007/s00264-015-2936-y ◽

2015 ◽

Vol 39 (9) ◽

pp. 1845-1849 ◽

Cited By ~ 4

Author(s):

Ralph Zettl ◽

Daphne Eschbach ◽

Steffen Ruchholtz

Keyword(s):

Minimally Invasive ◽

Elderly Patients ◽

Acetabular Fractures ◽

Minimally Invasive Approach ◽

Invasive Approach

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Indirect Reduction Maneuver and Minimally Invasive Approach for Displaced Proximal Humerus Fractures in Elderly Patients

Clinics in Orthopedic Surgery ◽

10.4055/cios.2013.5.1.66 ◽

2013 ◽

Vol 5 (1) ◽

pp. 66 ◽

Cited By ~ 12

Author(s):

Sung-Weon Jung

Keyword(s):

Minimally Invasive ◽

Elderly Patients ◽

Proximal Humerus ◽

Proximal Humerus Fractures ◽

Indirect Reduction ◽

Minimally Invasive Approach ◽

Invasive Approach ◽

Humerus Fractures

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Comparative study of minimally invasive and traditional approaches for the microsurgical treatment of circle of Willis unruptured intracranial aneurysms

Innovative medicine of Kuban ◽

10.35401/2500-0268-2020-19-3-20-28 ◽

2020 ◽

pp. 20-28

Author(s):

R. S. Dzhindzhikhadze ◽

G. V. Danilov ◽

O. N. Dreval ◽

V. A. Lazarev ◽

A. V. Polyakov ◽

...

Keyword(s):

Minimally Invasive ◽

Intracranial Aneurysms ◽

Traditional Approach ◽

Invasive Technique ◽

Complication Rates ◽

Minimally Invasive Approach ◽

Invasive Approach ◽

Microsurgical Treatment ◽

Unruptured Intracranial Aneurysms ◽

Surgery Duration

Objective. The study objective was to compare the effects of minimally invasive and traditional surgical approaches for treating patients with unruptured intracranial aneurysms (UIAs) to assess efficacy and safety of the keyhole concept in neurosurgery.Material and methods. We made a comparison of the microsurgical treatment outcomes of 204 patients harbouring UIAs who were operated on in the period from 2014 to 2019. Patients were divided into two groups: operated on using traditional approach (n = 85, 41.7%) and minimally invasive approach (n = 119, 58.3%). Patients of the first group were operated on using pterional (n = 31), orbitozygomatic (n = 16) and lateral supraorbital (n = 38) approaches; the second group patients underwent surgery using trans-eyebrow supraorbital (n = 35), minimal pterional (n = 38), trans-eyebrow transorbital (n = 20) and transpalpebral transorbital (n = 26) approaches. Rate of intraoperative and postoperative complications, surgery duration and postoperative in-hospital stay period were the factors to compare. The Modified Rankin Scale was used as a neurological outcomes measure. Also cosmetic results of surgery, hypesthesia from the site of the surgical approach, temporomandibular joint disorder and facial asymmetry were evaluated.Results. Compared to the traditional approach, minimally invasive technique incurred shorter surgery duration (р = 0.051) and inpatient stay (р > 0.001). Intraoperative and postoperative complication rates (р > 0.05) as well as functional outcomes (р > 0.05) were comparable between the two groups, while cosmetic effects (р < 0.05) were greater in minimally invasive group of UIA patients.Conclusion. Microsurgical treatment of UIA patients using minimally invasive approach is considered safe and effective. Adequate selection of patients for operation and exhaustive neuroimaging data assessment for choosing of neurosurgical technique are obligatory factors for keyhole surgery. The authors recommend using minimally invasive concept only for experienced neurosurgical teams in specialized clinics.

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