scholarly journals Subtemporal approach to basilar tip aneurysm with division of posterior communicating artery: Technical note

2008 ◽  
Vol Volume 4 ◽  
pp. 931-935 ◽  
Author(s):  
Shunsuke Kakino
Neurosurgery ◽  
1991 ◽  
Vol 28 (3) ◽  
pp. 456-459 ◽  
Author(s):  
Luca Regli ◽  
Nicolas de Tribolet

Abstract The authors present a case of a tuberothalamic infarct subsequent to division of the posterior communicating artery for clipping of a high-lying aneurysm of the basilar bifurcation using the pterional approach. In view of this clinical observation and some particular aspects of the microsurgical anatomy of the perforating vessels of the posterior communicating artery, we conclude that interrupting this parent vessel carries a significant risk of infarction.


Medicina ◽  
2007 ◽  
Vol 43 (7) ◽  
pp. 562 ◽  
Author(s):  
Edvardas Žurauskas ◽  
Jurgita Ušinskienė ◽  
Virginija Gaigalaitė ◽  
Raphael Blanc ◽  
Andrius Ušinskas ◽  
...  

Objective. To delineate technical aspects of vascular models with intracranial aneurysm in vitro production, suitable for angiographic imaging. Material and methods. Wax (K2 exact, S-U-CERAMO-CAPS-WAX), Girtl’s mass, gelatin, and silicone (Silicone 10015 Den Braven, Elastosil 7683/25, Elite Double 32 Shore-A, Rema-Sil) were used for model production. Construction of models was based on T-shaped plastic tube connections and lost core techniques. Images of rotational angiography, glass tubes with aneurysm, and casts obtained in human specimen were used as samples of cerebral arteries. Results. Technical aspects of vascular models production were delineated in experience of eight silicone models produced. M1 was hand made with basilar tip aneurysm; M2 was obtained according to angiography images with internal carotid artery supraclinoid part bifurcation to anterior and middle cerebral artery aneurysm. BM1 and BM2 casts were made using glass tubes with lateral aneurysm, M3 – from T-shaped plastic tubes with lateral aneurysms. M4, M5, and M6 were formed using casts obtained in human specimen with basilar tip aneurysm. Conclusions. Silicone of two components is practical for casts of cerebral arteries in human specimen production. Gelatinous solution 50°C diluted 1:1 with water can be used for copies of arterial casts production. Wax materials are unsuitable for making casts in a human specimen.


1996 ◽  
Vol 138 (7) ◽  
pp. 853-861 ◽  
Author(s):  
S. Inao ◽  
H. Kuchiwaki ◽  
N. Hirai ◽  
T. Gonda ◽  
M. Furuse

2014 ◽  
Vol 37 (v1supplement) ◽  
pp. 1
Author(s):  
Vijay Agarwal ◽  
Ali Zomorodi ◽  
Cameron Mcdougal ◽  
Ranjith Babu ◽  
Adam Back ◽  
...  

We present the case of a balloon-assisted, stent-supported coil embolization of a basilar tip aneurysm. Initially, a balloon extending from the basilar artery into the right PCA was placed.3 However, even with a more proximal purchase, coils were found to impinge on the left PCA. Subsequently, a transcirculation approach was performed, where the left posterior communicating artery was utilized as a conduit for balloon support and the coils were embolized from the ipsilateral vertebral artery.1 However, after this transcirculation approach was completed, there was a coil tail extruding from the aneurysm. The balloon was then removed over an exchange wire and a horizontal stent advanced, spanning the entire neck of the aneurysm, eliminating the extruded coil.2The video can be found here: http://youtu.be/bMbtZoPnYvo.


2014 ◽  
Vol 7 (10) ◽  
pp. e33-e33 ◽  
Author(s):  
Ciro Vasquez ◽  
Molly Hubbard ◽  
Bharathi Dasan Jagadeesan ◽  
Ramachandra Prasad Tummala

2017 ◽  
Vol 13 (3) ◽  
pp. 309-316 ◽  
Author(s):  
Akitsugu Kawashima ◽  
Hugo Andrade-Barazarte ◽  
Behnam Rezai Jahromi ◽  
Minna Oinas ◽  
Ahmed Elsharkawy ◽  
...  

Abstract BACKGROUND: Posterior cerebral artery (PCA) aneurysms are rare and the majority are fusiform in shape. Proximal occlusion of PCA represents a treatment option for these lesions. However, this procedure carries a high risk of ischemic complications. OBJECTIVE: To describe the technique of trapping a fusiform PCA aneurysm and revascularization of the distal PCA using a superficial temporal artery (STA) graft through the same microsurgical approach. METHODS: From September 2012 to October 2014, we retrospectively identified 3 patients harboring a fusiform PCA aneurysm (P2 segment aneurysm) who underwent trapping of the aneurysm and reconstruction of the distal PCA through the same subtemporal approach. We analyzed immediate morbidity, surgical complications, and the patency of the bypass to determine the feasibility of this procedure. RESULTS: All 3 patients underwent successful trapping of the fusiform PCA aneurysm and revascularization of the distal PCA. The origin of P3 segment or posterior temporal artery (PTA) served as recipient arteries. In all 3 cases, adequate blood flow was evident after performing the STA-P3/PTA bypass. None of the patients experienced a new permanent neurological deficit. At 1-year follow-up, the STA-PTA/PCA bypasses remained patent. CONCLUSION: The STA-P3/PTA bypass through the subtemporal approach is a feasible option to maintain blood flow in cases of PCA fusiform aneurysms requiring trapping of the P2 segment.


2017 ◽  
Vol 3 (3) ◽  
pp. 119-123
Author(s):  
Mohammad Ghorbani ◽  
Ebrahim Hejazian ◽  
◽  

2007 ◽  
Vol 30 (3) ◽  
pp. 203-207 ◽  
Author(s):  
Tetsuyoshi Horiuchi ◽  
Fukuo Nakagawa ◽  
Yuichiro Tanaka ◽  
Hiroshi Miyama ◽  
Kazuhiro Hongo

2005 ◽  
Vol 57 (suppl_4) ◽  
pp. ONS-E408-ONS-E408 ◽  
Author(s):  
Juha Hernesniemi ◽  
Keisuke Ishii ◽  
Ayse Karatas ◽  
Leena Kivipelto ◽  
Mika Niemelä ◽  
...  

Abstract OBJECTIVE: To describe a surgical technique to retract the tentorial edge during the subtemporal approach initially introduced and used widely by Drake and Peerless to treat distal basilar artery aneurysms. METHODS: One of the most important parts of the exposure is to reflect the edge of the tentorium downward by 1 cm or more and to tether it with a suture placed lateral to or behind the insertion of the trochlear nerve and then to the dura mater of the floor of the middle fossa. Surgical forceps or a sharp dural hook are used to elevate the tentorial edge, in front of the trochlear nerve. A small incision is made on the surface of the floor of the middle fossa using a sharp bipolar forceps, and a small straight microclip is inserted with one arm through the incision on the surface of the floor of the middle fossa and the other at the free margin of the tentorial edge. RESULTS: The method described has been used by the senior author in more than 100 operations as a simple and fast means of tethering the free margin of the tentorial edge simply and quickly. CONCLUSION: We inserted a small straight microclip with one arm through the incision on the surface of the floor of the middle fossa and the other at the free margin of the tentorial edge as a fast and simple method of retracting the tentorial edge during a subtemporal approach.


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