Clinical Researches
Balloon-assisted clipping for giant unruptured intracranial aneurysms of internal carotid artery
Zhong Bo, Zou Guorong, Xiong Zhiqiang, Luo Qingyong, Yang Xingda, Hu Youzhu, Zhang Donggen, Liao Yiwei
Published 2019-07-28
Cite as Int J Cerebrovasc Dis, 2019,27(7): 520-524. DOI: 10.3760/cma.j.issn.1673-4165.2019.07.008
Abstract
ObjectiveTo investigate the efficacy and clinical value of balloon-assisted clipping for the treatment of giant unruptured intracranial aneurysms of internal carotid artery.
MethodsPatients with giant unruptured intracranial aneurysm of intracranial segment of internal carotid artery treated with balloon-assisted clipping in the Department of Neurosurgery, Xiangya Hospital, Central South University from September 2017 to May 2018 were enrolled retrospectively. The proximal internal carotid artery or the aneurysm neck were temporarily blocked by balloon, and then the aneurysm was clipped in the hybrid operating room. Demographic data, preoperative symptoms, aneurysm characteristics, position of balloon placement, intraoperative angiography, complications, and follow-up results were collected.
ResultsA total of 12 patients with giant (diameter >2 cm) unruptured intracranial aneurysm of intracranial segment of internal carotid artery were enrolled. They were all successfully clipped using balloon-assisted clipping in the hybrid operating room. Among them, 1 was located in the ophthalmic segment, 3 in the supraclinoid segment, 4 in the posterior communicating segment, 2 in the anterior choroidal artery segment, and 2 in the bifurcation of the internal carotid artery. The balloons were placed in the proximal end of internal carotid artery in 9 cases and in the neck of aneurysm in 3 cases. Intraoperative angiography showed that 12 aneurysms were completely occluded; 1 had severe stenosis of parent artery, and 1 had mild stenosis. Postoperative complications included cerebral infarction in 1 case, temporary diabetes insipidus in 1 case (returned to normal 1 week after operation), hemiplegia in 1 case, and epilepsy in 1 case. Glasgow Outcome Scale score at discharge showed 5 in 9 cases, 4 in 2 cases, and 3 in 1 case. The patients were followed up for 2.3 to 12 months after operation (median 7.5 months). Reexamination of CT angiography showed no recurrence of aneurysm. Glasgow Outcome Scale score was 5 in 11 cases and 4 in 1 case.
ConclusionsThe use of balloon-assisted clipping technique in the hybrid operating room for the treatment of giant intracranial segmental aneurysms of the internal carotid artery is safe and effective, and has a good long-term outcome.
Key words:
Intracranial aneurysm; Carotid artery, internal; Microsurgery; Angioplasty, balloon; Operating room
Contributor Information
Zhong Bo
Department of Neurosurgery, Xinyu People's Hospital, Xinyu 338000, China
Zou Guorong
Department of Neurosurgery, Xinyu People's Hospital, Xinyu 338000, China
Xiong Zhiqiang
Department of Neurosurgery, Xinyu People's Hospital, Xinyu 338000, China
Luo Qingyong
Department of Neurosurgery, Xinyu People's Hospital, Xinyu 338000, China
Yang Xingda
Department of Neurosurgery, Xinyu People's Hospital, Xinyu 338000, China
Hu Youzhu
Department of Neurosurgery, Xinyu People's Hospital, Xinyu 338000, China
Zhang Donggen
Department of Neurosurgery, Xinyu People's Hospital, Xinyu 338000, China
Liao Yiwei
Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha 410008, China
