Side selection of the pterional approach for anterosuperior-pointing anterior communicating artery aneu-rysms / 中国神经精神疾病杂志

ABSTRACT

Objective To investigate the difficulty, safety and clinical efficacy of the pterional approach from the side of open A2 plane vs the approach from the side of closed A2 plane for anterosuperior-pointing anterior communicat?ing artery aneurysms (ACoAA). Methods Forty-two patients with anterosuperior-pointing ACoAA treated by microsurgi?cal clipping were divided into two groups of the approach from the side of open A2 plane (n=22) and the approach from the side of closed A2 plane (n=20). Primary objective endpoints were rates of gyrus rectus aspiration, displacement of the ipsilateral A2 and surgical-related complications, clipping results, incidence of cognitive function impairment and Glasgow Outcome Scale (GOS) at 6 months after treatment. Results The incidence of gyrus rectus aspiration and dis?placement of the ipsilateral A2, cognitive impairment at 6 months after treatment and the surgical-related complications was also significant lower in the approach from the side of open A2 plane than in the approach from the side of closed A2 plane [4(18.2%) cases vs. 11(55.0%) cases, χ2=6.185, P0.05). Conclusions The pterional approach from the side of open A2 plane in patients with anterosuperior-pointing ACoAA allows the aneurysmal necks to be secured safely, decreases operation difficulty and prevents surgical-related complications.