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An attempt was made to clip the neck of a large paraclinoid aneurysm with the support of a balloon catheter, using a trapping-evacuation technique. The clip applied to the neck slipped off because of blood pressure through the posterior communicating artery which arose from the dome of the aneurysm. Therefore, using portable digital subtraction angiography (DSA) equipment, we placed interlocking detachable coils (IDCs) in the aneurysm for the purpose of reducing the intraaneurysmal pressure. Although the aneurysm was eventually trapped with two clips, this case indicates the supportive role of intravascular intervention in aneurysmal surgery when clipping an aneurysm or immediately after clip failure.
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http://dx.doi.org/10.1177/15910199980040S118 | DOI Listing |
J Neurosurg
August 2025
Departments of1Neurological Surgery.
Objective: The endoscopic endonasal approach (EEA) provides a ventral surgical corridor, which can be advantageous in the management of carefully selected cerebral aneurysms. The literature lacks large series to better delineate the indications and limitations of this technique. The aim of this study was to elucidate the technique's safety, indications, advantages, and limitations, as well as its evolution over time.
View Article and Find Full Text PDFNeurol India
July 2025
Department of Neurosurgery, LTMG Hospital, Sion, Mumbai, Maharashtra, India.
Superior hypophyseal artery aneurysms are rare. Symptomatic superior hypophyseal artery aneurysm commonly presents with subarachnoid hemorrhage, uncommonly with cranial nerve deficits, and very rarely with visual impairment. Microsurgical management of such aneurysms is quite complex considering the anatomical structures in the paraclinoid region.
View Article and Find Full Text PDFWorld Neurosurg
March 2025
Department of Neurosurgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan. Electronic address:
Radiol Case Rep
September 2024
City Clinical Hospital No. 1, Leninsky Prospekt, 8, Moscow 119049, Russian Federation.
Paraclinoid internal carotid artery (ICA) aneurysms are associated with a high mortality rate, which gradually increases without intervention. Surgical clipping or coiling of large aneurysms with inadequate neck and adductor artery expansion will not guarantee a successful outcome. Carotid surgical trapping or endovascular occlusion of the adductor artery can help to isolate the aneurysm from circulation, but it comes at the expense of sacrificing a major blood vessel responsible for significant cerebral perfusion.
View Article and Find Full Text PDFWorld Neurosurg
May 2024
Neuroradiology, Hôpital Güi-de-Chauliac, CHU de Montpellier, Montpellier, France.
Background: To determine the clinical effects (stent size, and number of stents used) of the Sim&Size™ simulation software on the endovascular treatment of unruptured saccular intracranial aneurysms with Pipeline Embolization Devices (PED).
Methods: This study is a retrospective analytical multicenter study of patients treated with PED (Flex and Flex with SHIELD) for intracranial aneurysm in FOSCAL clinic and CHU de Montpellier.
Results: The study included 253 patients, of which 75 were treated in Colombia and 178 were treated in France.