Preventive brain aneurysm clipping: decision making and importance of surgical techniques for the optimal outcome
Abstract
Factors that should considered in the assessment of the risks and benefits of different treatment options, including an analysis of cumulative risk of aneurysm rupture during the life expectancy are described. Surgical technique is presented in the illustrative case of a patient with an unruptured anterior communicating artery aneurysm. Skill of sharp arachnoidal dissection by micro-scissors in different directions is an important component of operative technique for opening of arachnoidal cysterns and dissection of arachnoid membrane adhesions that allows to perform adequate brain relaxation by removing the liquor, as well as producing a bloodless exposure to areas of interest, access to the proximal and distal vascular branches for temporarily clipping. Sharp dissection is important for identification and protection of perforating and exiting arterial branches, dissection of aneurysm neck without tension of aneurysmal sac walls by arachnoid adhesions.
About the Authors
E. G. Belykh
Irkutsk Scientific Center of Surgery and Traumatology
Russian Federation
Russian Federation
K. .. Kikuta
Division of Neurosurgery, Faculty of Medical Sciences, University of Furui
Russian Federation
Russian Federation
G. S. Zhdanovich
Irkutsk State Medical University
Russian Federation
Russian Federation
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Review
For citations:
Belykh E.G., Kikuta K..., Zhdanovich G.S. Preventive brain aneurysm clipping: decision making and importance of surgical techniques for the optimal outcome. Pacific Medical Journal. 2015;(4):59-62. (In Russ.)
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