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2019, Number 3

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Arch Neurocien 2019; 24 (3)

Treatment options in giant paraclinoid aneurisms: a first case with surgical and endovascular management of Fray Antonio Alcalde Civil Hospital

Ramírez-Huerta CA, Estrella-Sánchez CF, Múñoz-López JA, Ledezma-González JE, Núñez-Velasco S
Full text How to cite this article

Language: Spanish
References: 12
Page: 37-43
PDF size: 623.63 Kb.


Key words:

aneurism, flow diverter, paraclinoid.

ABSTRACT

Introduction: Paraclinoid aneurysm are a complex carotid vascular patology that originates between the proximal dural ring and the posterior communicating artery. They are classified in order of size, location and projection. Actually exist two main currents for their treatment: the microsurgical way and the endovascular way.
Case report: A 56 years old woman that presents with headache 3 months before admission is referenced to our service where it was diagnose with a not ruptured left paraclinoid aneurysm of the oftalmic segment. First is subjected to a microsurgical procedure where it was not possible to ensure a safe clipping, subsequently it is decided to place a flow diverter in the hemodynamic unit; the patient its discharged whitout complications and with a total occlusion of the aneurysm.
Conclusion: Paraclinoid anaeurisms are a complex patology with a high rate of morbidity, for their proper handling and treatment it is advisable to count on a well equipped center that can offer the microsurgical and endovascular treatment options.


REFERENCES

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  2. Pahl F, Oliveira M, Brock R, Lucio J and Rotta J. Surgical clipping is still a good choice for the treatment of paraclinoid aneurysms. Arquivos De Neuro-Psiquiatria 2016; 74(4):314-319. doi:10.1590/0004-282x20150215.

  3. Ansari A, Yamada Y, Sae-Ngow T, Tanaka R, Kawase T, Kalyan S, et al. Microsurgical treatment of paraclinoid aneurysms by extradural anterior clinoidectomy: the fujita experience. Asian J Neurosurg 2019;14(3):868.

  4. Wang J, Wu J, Cao Y, Kan Z, Wang S. Comparison between frontolateral approach and pterional approach in the surgical treatment of paraclinoid aneurysms. J Clin Neurosci 2018; 52:80-87.

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  8. Liebman K, Hedayat H and Elwood A. Specifics of aneurysm treatment: paraclinoid internal carotid artery. Intracranial Aneurysms, 483-497. doi: 10.1016/b978-0-12-811740-8.07000-3

  9. Silva MA, See AP, Khandelwal P, Mahapatra A, Frerichs KU, et al. Comparison of flow diversion with clipping and coiling for the treatment of paraclinoid aneurysms in 115 patients. J Neurosurg 2018; 1-8. doi: 10.3171/2018.1.jns171774

  10. Jia ZY, Song YS, Sheen JJ, Kim JG, Lee CW and Suh DC. Loop microcatheter technique for coil embolization of paraclinoid aneurysms. Acta Neurochir 2018; 160(9):1755-1760. doi: 10.1007/s00701-018-3642-5

  11. Sheen J, Park W, Kwun B, Park J, Ahn, J. Microsurgical treatment strategy for large and giant aneurysms of the internal carotid artery. Clin Neurol Neurosurg 2019; 177, 54-62. doi: 10.1016/j.clineuro.2018.12.014

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Arch Neurocien. 2019;24