Modified Supraorbital Keyhole Approach to Anterior Circulation Aneurysms
Journal of Cerebrovascular and Endovascular Neurosurgery
;
: 5-11, 2016.
Artigo
em Inglês
| WPRIM
| ID: wpr-79570
ABSTRACT
OBJECTIVE:
To select a surgical approach for aneurysm clipping by comparing 2 approaches. MATERIALS ANDMETHODS:
204 patients diagnosed with subarachnoid hemorrhage treated by the same neurosurgeon at a single institution from November 2011 to October 2013, 109 underwent surgical clipping. Among these, 40 patients with Hunt and Hess or Fisher grades 2 or lower were selected. Patients were assigned to Group 1 (supraorbital keyhole approach) or Group 2 (modified supraorbital approach). The prognosis according to the difference between the two surgical approaches was retrospectively compared.RESULTS:
Supraorbital keyhole approach (Group 1) was performed in 20 aneurysms (50%) and modified supraorbital approach (Group 2) was used in 20 aneurysms. Baseline characteristics of patients did not differ significantly between two groups. Total operative time (p = 0.226), early ambulation time (p = 0.755), length of hospital stay (p = 0.784), Glasgow Coma Scale at discharge (p = 0.325), and Glasgow Outcome Scale scores (p = 0.427) did not show statistically significant differences. The amount of intraoperative hemorrhage was significantly lower in the supraorbital keyhole approach (p < 0.05).CONCLUSION:
The present series demonstrates the safety and feasibility of the two minimal invasive surgical techniques for clipping the intracranial aneurysms. The modified supraorbital keyhole approach was associated with more hemorrhage than the previous supraorbital keyhole approach, but did not exhibit differences in clinical results, and provided a better surgical view and convenience for surgeons in patients with Hunt and Hess or Fisher grades 2 or lower.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Prognóstico
/
Hemorragia Subaracnóidea
/
Instrumentos Cirúrgicos
/
Escala de Coma de Glasgow
/
Aneurisma Intracraniano
/
Estudos Retrospectivos
/
Procedimentos Cirúrgicos Minimamente Invasivos
/
Craniotomia
/
Escala de Resultado de Glasgow
/
Deambulação Precoce
Tipo de estudo:
Estudo observacional
/
Estudo prognóstico
Limite:
Humanos
Idioma:
Inglês
Revista:
Journal of Cerebrovascular and Endovascular Neurosurgery
Ano de publicação:
2016
Tipo de documento:
Artigo
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