Microsurgical procedures and the results of supraclinoid internal carotid aneurysms / 中国医师进修杂志

ABSTRACT

Objective To analyze the features of supraclinoid internal carotid aneurysms. The experience and mistakes in the microsurgery of supraclinoid internal carotid aneurysms were summarized to improve the results. Methods The data of 24 cases of supraclinoid internal carotid aneurysms that were operated from May 2004 to March 2009 were reviewed. There were 6 cases of small or middle aneurysms, 18 cases of large or giant aneurysms. The operative methods included direct clipping, partial excision of aneurysm with reconstruction of the parent artery, aneurysm trapping with extracerebral/intracerebral (EC-IC) bypass, etc. Results Among the 24 cases, 8 cases had good results. Ten cases occurred hemiplegja post operation immediately, with 5 cases recovered to grade IV ,3 cases had aphasia,5 cases with vision acuity fall,4 cases had abnormal eyeball movement,2 cases had continued coma and died finally. Second operations were performed in 3 cases. The total operation rate of well results was 66.7% (16/24). Mortality rate was 8.3% (2/24). Conclusions The operative technique of the supraclinoid internal carotid aneurysms is difficult because of the location and the large size of the aneurysms. The temporary obstruction' of the parent artery is often needed, so the aneurysm can be partially resected and clipped. The results of clipping of large or giant aneurysms are better than the other methods. But in large or giant aneurysms that had thrombus, the EC-IC bypass is needed to prevent large infarction. The bypass procedure may induce some severe complications that result in some poor outcome.