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Journal of Korean Neurosurgical Society > Volume 32(5); 2002 > Article
Journal of Korean Neurosurgical Society 2002;32(5): 419-423.
The Clipping on Supraclinoid Internal Carotid Artery Aneurysms.
Kyoung Soo Ryou, In Suk Hamm, Seung Lae Kim
Department of Neurosurgery, College of Medicine, Kyungpook National University, Daegu, Korea. ishamm@knu.ac.kr
ABSTRACT
OBJECTIVE:
We present a clinical analysis to envision the difficulties in supraclinoid internal carotid artery(ICA) aneurysmal neck clippings to improve the postoperative outcome.
METHODS:
Two hundred and fifty aneurysm surgeries were undertaken at our hospital from 1997 to 1998. There were 52 patients(20.4% of the total) of supraclinoid ICA saccular aneurysmal patients. Eighteen cases(34.6%) were found with diverse difficulties in direct neck clippings. The authors analyzed the causes of surgical difficulties in the clipping on supraclinoid ICA aneurysms, in a clinical perspective.
RESULTS:
Perfect aneurysmal clippings were performed in 45 patients(86.5%) of the total 52 cases of supraclinoid ICA aneurysms. The clipping and wrapping were needed in five cases(9.6%), trapping in one(1.9%) with one case(1.9%) needed only for wrapping. The causes of difficulties in direct neck clipings were : aneurysm sac involving perforator in six cases(11.5%), too short an ICA proximal to posterior communicating artery for temporary clipping in 5(9.6%), posterior communicating artery aneurysm directed to the ventral side in three(5.8%), dorsal wall aneurysm in one, severe atheromatous ICA in one, a larger sac than in angiographic finding with partial thrombosis in one, severe adhesion of aneurysm to 3rd cranial nerve in one patient.
CONCLUSION:
For supraclinoid ICA aneurysm surgery, sufficient preoperative plans and careful inspection including angiographic findings to foresee the various difficulties of neck clippings are needed.
Key Words: Aneurysm; Supraclinoid; Clipping; Trapping
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