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CC BY-NC-ND 4.0 · Asian J Neurosurg 2019; 14(03): 868-872
DOI: 10.4103/ajns.AJNS_130_17
Original Article

Microsurgical treatment of paraclinoid aneurysms by extradural anterior clinoidectomy: The fujita experience

Yasuhiro Yamada
Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, Nagoya
,
Ahmed Ansari
Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, Nagoya
,
Treepob Sae-Ngow
Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, Nagoya
,
Riki Tanaka
Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, Nagoya
,
Tsukasa Kawase
Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, Nagoya
,
Sai Kalyan
Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, Nagoya
,
Yoko Kato
Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, Nagoya
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Introduction: Paraclinoid aneurysms pose technical difficulty in their approach, mainly because of their close proximity to neurovascular structures, deeper location, and a smaller corridor. Extradural anterior clinoidectomy is a highly beneficial technique in such cases, making more space to deal with these aneurysms. We describe our method of performing extradural anterior clinoidectomy in such patients. Materials and Methods: A total of 33 cases of paraclinoid internal carotid artery aneurysms presenting to Fujita Health University Banbuntane Hospital, Japan, were included. Females comprised the majority with 32 cases; the mean age was 54.8 years (range: 35–74 years). The mean size of the paraclinoid aneurysm was 5.3 mm (range: 3–12 mm). Results: Nine paraclinoid aneurysms were found projecting dorsally, 7 laterally, and 17 medially (Kazuhiko Kyoshim et al's. classification). An immediate complete occlusion rate of 100% was present. Visual disturbance was found in 6.2% of our patients. One of our patients developed permanent loss of vision. Conclusion: Extradural anterior clinoidectomy enables a better exposure to paraclinoid aneurysms. Precise anatomical knowledge along with microsurgical tactics is required to prevent and manage potential complications to achieve good outcomes.

Key-words:

Aneurysms - extradural anterior clinoidectomy - paraclinoid

Financial support and sponsorship

Nil.




Publication History

Article published online:
09 September 2022

© 2019. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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