Dolenc approach for clipping of giant C6 and C7 segment aneurysms of the internal carotid artery

Frontiers in Surgery

Surgery

Wei Liu¹  Dong Zhang²  Aimin Li³  Yan Gu³  Hongwei Zhang⁴ 

[1] Department of Neurosurgery, Beijing Tiantan Hospital Affiliated to Capital Medical University, Beijing, China;Department of Neurosurgery, Beijing Tiantan Hospital Affiliated to Capital Medical University, Beijing, China;Department of Neurosurgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China;Department of Neurosurgery, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, China;Department of Neurosurgery, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, China;Department of Neurosurgery, Beijing Tiantan Hospital Affiliated to Capital Medical University, Beijing, China;

关键词: Dolenc approach;    giant aneurysm;    internal carotid artery;    ophthalmic aneurysm;    anterior clinoid process;    posterior communicating artery aneurysm;   

DOI  :  10.3389/fsurg.2023.1222386

 received in 2023-05-14, accepted in 2023-08-01,  发布年份 2023

来源: Frontiers

【 摘 要 】

ObjectiveSurgical treatment for giant aneurysms of the ICA-ophthalmic segment (C6) and communicating artery segment (C7) is a challenge for neurosurgeons because of their high risks and poor outcomes. We aim to explore the advantages and disadvantages of the Dolenc approach in the treatment of giant C6–C7 segment aneurysms.MethodsWe retrospectively reviewed the clinical data of 13 cases with giant C6 aneurysms and 4 cases with giant C7 aneurysms treated with the Dolenc approach.ResultsAll 17 cases of aneurysms were clipped successfully using the Dolenc approach, of which, 1 case with ipsilateral MCA occlusion underwent extracranial-intracranial artery bypass after the aneurysm clipping. Regarding clinical outcomes, six out of nine cases with preoperative visual impairment improved after surgery, two cases saw no change, and one case deteriorated. Of all the cases, one had new-onset vision loss, four had new-onset oculomotor paralysis, three had surgical side cerebral infarction, and two had diabetes insipidus. DSA or CTA examination within 2 weeks after surgery showed that all aneurysms were completely clipped without residual. After a follow-up of 9–12 months, 17 patients were evaluated based on GOS and CTA examination. A total of 14 cases had GOS 5 scores, 2 cases had GOS 4 scores, 1 case had GOS 2 scores, and no cases had death. None of the patients had recurrence based on CTA examinations.ConclusionThrough the Dolenc approach, we could achieve more operation space and expose clinoid segments for temporary occlusion. Therefore, the Dolenc approach was shown to be a safe, effective, and feasible treatment for giant C6–C7 aneurysms.

【 授权许可】

Unknown   
© 2023 Zhang, Liu, Gu, Li and Zhang.