Dokument: Trans-lateral ventricular approach for surgical treatment of high-located P2–P3 junction posterior cerebral artery aneurysms: from anatomical research to clinical application

Titel:Trans-lateral ventricular approach for surgical treatment of high-located P2–P3 junction posterior cerebral artery aneurysms: from anatomical research to clinical application
URL für Lesezeichen:https://docserv.uni-duesseldorf.de/servlets/DocumentServlet?id=67703
URN (NBN):urn:nbn:de:hbz:061-20241126-094323-7
Kollektion:Publikationen
Sprache:Englisch
Dokumententyp:Wissenschaftliche Texte » Artikel, Aufsatz
Medientyp:Text
Autoren: Muhammad, Sajjad [Autor]
Zhang, Rui [Autor]
Filler, Tim [Autor]
Hänggi, Daniel [Autor]
Meling, Torstein R. [Autor]
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Dateien vom 26.11.2024 / geändert 26.11.2024
Stichwörter:Cerebrovascular disease, Surgical clipping, Posterior cerebral artery aneurysms, Trans-lateral ventricular approach
Beschreibung:Background

Posterior cerebral artery (PCA) aneurysms, though rare, pose treatment challenges. Endovascular therapy is the preferred option, but microsurgery becomes necessary in certain cases. Various microsurgical approaches have been suggested for PCA aneurysms, particularly those at the P2–P3 junction. This study highlights the trans-lateral ventricular approach (TVA) for addressing these complex aneurysms. This study aims to assess the feasibility and safety of the trans-lateral ventricular approach (TVA) for treating high-located complex PCA aneurysms at the P2–P3 junction. The study evaluates both clinical outcomes and anatomical considerations.
Methods

Two cases of PCA aneurysms at the P2–P3 junction were treated using TVA in 2019. Navigation-guided entry via the interparietal sulcus was planned. Ventriculostomy was performed from the cortex to the lateral ventricle’s atrium. Medial atrial floor dissection exposed PCA’s P2–P3 segments. Neuronavigation and ultrasound-aided guidance was used. Anatomical studies on fixed and contrast-perfused specimens refined the approach.
Results

Both cases saw successful aneurysm clipping. The unruptured aneurysm patient was discharged in 6 days. The poor-grade SAH patient required extended ICU care, moving to rehabilitation with mRS = 4. The unruptured complex aneurysm case exhibited no deficits, returning to work in 3 months. Anatomical dissections validated TVA for high-located P2–P3 junction PCA aneurysms.
Conclusion

While endovascular therapy remains primary, this study demonstrates the viability of navigation-guided TVA for select high-located P2–P3 junction PCA aneurysms. Successes and challenges underscore the importance of patient selection and anatomical awareness.
Rechtliche Vermerke:Originalveröffentlichung:
Muhammad, S., Zhang, R., Filler, T., Hänggi, D., & Meling, T. R. (2024). Trans-lateral ventricular approach for surgical treatment of high-located P2–P3 junction posterior cerebral artery aneurysms: from anatomical research to clinical application. Acta Neurochirurgica, 166, Article 50. https://doi.org/10.1007/s00701-024-05942-1
Lizenz:Creative Commons Lizenzvertrag
Dieses Werk ist lizenziert unter einer Creative Commons Namensnennung 4.0 International Lizenz
Fachbereich / Einrichtung:Medizinische Fakultät
Dokument erstellt am:26.11.2024
Dateien geändert am:26.11.2024
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