PDF(Pubmed)
Abstract：
BACKGROUND: Giant ophthalmic artery (OphA) aneurysms remain surgically challenging despite the progress in endovascular treatments. This study describes the contralateral interoptic corridor in select patients based on imaging criteria suitable for clipping. The aim of this study was to show that despite the growing use of novel endovascular techniques, such as coil embolization and flow diversion, for the treatment of OphA aneurysms, microsurgical clipping may still be preferred for giant ones under certain conditions.
METHODS: The authors retrospectively reviewed the records of the microsurgical treatment of unruptured and ruptured giant OphA aneurysms at the University Hospital Center \"Mother Teresa,\" Tirana, from 2007 to 2016. Four patients were selected for microsurgery and the contralateral approach using ophthalmic evaluations and coronal imaging on computed tomography, magnetic resonance imaging, and digital subtraction angiography that demonstrated aneurysms with a small neck and an orientation between 11 and 13 on the coronal clock face. A prefixed chiasm was a contraindication to this approach.
CONCLUSIONS: Giant OphA aneurysms can be safely clipped through a contralateral interoptic corridor without creating new visual deficits or a residual aneurysm. https://thejns.org/doi/10.3171/CASE2473.
METHODS: The authors retrospectively reviewed the records of the microsurgical treatment of unruptured and ruptured giant OphA aneurysms at the University Hospital Center \"Mother Teresa,\" Tirana, from 2007 to 2016. Four patients were selected for microsurgery and the contralateral approach using ophthalmic evaluations and coronal imaging on computed tomography, magnetic resonance imaging, and digital subtraction angiography that demonstrated aneurysms with a small neck and an orientation between 11 and 13 on the coronal clock face. A prefixed chiasm was a contraindication to this approach.
CONCLUSIONS: Giant OphA aneurysms can be safely clipped through a contralateral interoptic corridor without creating new visual deficits or a residual aneurysm. https://thejns.org/doi/10.3171/CASE2473.
摘要：
背景：巨大眼动脉（OphA）动脉瘤尽管在血管内治疗方面取得了进展，但在手术上仍然具有挑战性。这项研究根据适合夹闭的成像标准描述了某些患者的对侧视间走廊。这项研究的目的是表明，尽管越来越多地使用新的血管内技术，如线圈栓塞和分流，用于治疗OphA动脉瘤，在某些情况下，显微手术夹钳可能仍然是巨大的首选。
方法：作者回顾性回顾了大学医院中心“特蕾莎修女，\"地拉那,从2007年到2016年。选择四名患者进行显微外科手术和对侧入路，使用眼科评估和计算机断层扫描的冠状成像，磁共振成像，和数字减影血管造影显示动脉瘤的颈部较小，在冠状时钟面上的方向在11和13之间。前缀交叉是这种方法的禁忌症。
结论：巨大的OphA动脉瘤可以通过对侧视间通道安全地夹住，而不会产生新的视觉缺陷或残留动脉瘤。https://thejns.org/doi/10.3171/CASE2473.
方法：作者回顾性回顾了大学医院中心“特蕾莎修女，\"地拉那,从2007年到2016年。选择四名患者进行显微外科手术和对侧入路，使用眼科评估和计算机断层扫描的冠状成像，磁共振成像，和数字减影血管造影显示动脉瘤的颈部较小，在冠状时钟面上的方向在11和13之间。前缀交叉是这种方法的禁忌症。
结论：巨大的OphA动脉瘤可以通过对侧视间通道安全地夹住，而不会产生新的视觉缺陷或残留动脉瘤。https://thejns.org/doi/10.3171/CASE2473.
