| Applied anatomical study of clipping bilateral intracranial aneurysms via unilateral pterional keyhole approach |
| Received:September 13, 2020 Revised:November 29, 2020 Click here to download the full text |
| Citation of this paper:YANG Hua,LI Ai-min,LIU Xi-guang,ZHOU Jing,QIU Jin-song,GAO Feng,ZHOU Hai.Applied anatomical study of clipping bilateral intracranial aneurysms via unilateral pterional keyhole approach[J].Chinese Journal of Clinical Medicine,2020,27(6):1032-1036 |
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| Author Name | Affiliation | E-mail | | YANG Hua | Department of Neurological Surgery, People's Hospital of Binhai County, Yancheng 224000, Jiangsu, China | | | LI Ai-min | Department of Neurological Surgery, Lianyungang Hospital, Xuzhou Medical University, Lianyungang 222002, Jiangsu, China | 1127595015@qq.com | | LIU Xi-guang | Department of Neurological Surgery, Lianyungang Hospital, Xuzhou Medical University, Lianyungang 222002, Jiangsu, China | | | ZHOU Jing | Department of Neurological Surgery, People's Hospital of Binhai County, Yancheng 224000, Jiangsu, China | | | QIU Jin-song | Department of Neurological Surgery, People's Hospital of Binhai County, Yancheng 224000, Jiangsu, China | | | GAO Feng | Department of Neurological Surgery, People's Hospital of Binhai County, Yancheng 224000, Jiangsu, China | | | ZHOU Hai | Department of Neurological Surgery, People's Hospital of Binhai County, Yancheng 224000, Jiangsu, China | |
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| Abstract:Objective:To explore the basic and clinical anatomy of unilateral pterional keyhole approach for clipping bilateral intracranial aneurysms.Methods:30 sides of 15 cadavers of skull specimens (pterional keyhole approach, PTK) was simulated for craniotomy. The main intracranial vessels, including distal carotid artery (DICA), anterior cerebral artery (ACA), middle cerebral artery (MCA), and ophthalmic segment of internal carotid artery (OICA) were observed under microscope. The maximum lengths that can be observed were measured to provide anatomical data for clinical purposes. To further apply it to clinical practice, a modified Salma surgical exposure scale was introduced to quantify the score.Results:The contralateral A1 segment, proximal A2 segment, M1 segment, DICA, and OICA could be exposed through PTK; the contralateral A2 segment (lateral), M1 segment (posterior), M2 segment, MCAB (inferior), DICA (posterior and lateral), and OICA (superior, inferior, and lateral) could not be fully exposed to perform simulated surgical clipping (operability rate less than 75%).Conclusion:Contralateral aneurysms of A1 segment, A2 segment (anterior, posterior, and medial), M1 segment (anterior, superior, and inferior), MCAB (superior and lateral), ICAB, DICA (anterior and medial), and OICA (medial) could be fully exposed from different angles, and could be performed with surgical maneuvers via supraorbital eyebrow keyhole approach. |
| keywords:pterional keyhole approach contralateral approach cerebral aneurysm anatomy |
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