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Tips and Tricks in Microsurgical Treatment for Previously Embolized Aneurysms-Three-Dimensional Video.
Paganelli, Samantha Lorena; Alejandro, Sebastián Aníbal; Campos Filho, José Maria; Dória-Netto, Hugo Leonardo; Chaddad-Neto, Feres.
Afiliação
  • Paganelli SL; Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil.
  • Alejandro SA; Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil.
  • Campos Filho JM; Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil; Hospital Beneficência Portuguesa de São Paulo, São Paulo, São Paulo, Brazil.
  • Dória-Netto HL; Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil; Hospital Beneficência Portuguesa de São Paulo, São Paulo, São Paulo, Brazil.
  • Chaddad-Neto F; Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil; Hospital Beneficência Portuguesa de São Paulo, São Paulo, São Paulo, Brazil. Electronic address: feres.chaddad@unifesp.br.
World Neurosurg ; 163: 39, 2022 07.
Article em En | MEDLINE | ID: mdl-35427791
One of the most popular treatment strategies for complex cerebral aneurysms with wide necks is stent-assisted coiling.1 Although it is a minimally invasive technique, it is associated with higher recurrence rates (approximately 20%) compared with surgical clipping.2 Recanalization is more common principally in ruptured aneurysms as well as in giant aneurysms, aneurysms located in the posterior circulation, aneurysms with a relatively wide neck morphology, and aneurysms followed for >1 year.2-6 Tirakotai et al. classified the indications for surgical treatment after coiling into 3 groups: 1) surgery of incompletely coiled aneurysms; 2) surgery for mass effects on neural structures; 3) surgery for vascular complications.7 Recanalization, if significant, often requires retreatment. Retreating with additional coils fails in perhaps 50% of cases.3 On the other hand, surgical clipping is complicated and difficult to perform. Recanalized aneurysms are categorized into 3 types: type I, coils are compressed; type II, coils are migrated; type III, coils are migrated, and multiple coils fill its neck or the parent artery. Direct clipping can be applied to types I and II, whereas trapping, wrapping, or auxiliary revascularization is required in type III.2 Coil extraction should not be attempted regularly because it is associated with high morbidity.8 In this three-dimensional video, we present the microsurgical treatment of a type I recanalized anterior communicating artery aneurysm, which in serial digital subtraction angiography control scans showed residual patency, progressive growth, and changes in its hemodynamic behavior (Video).
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Aneurisma Intracraniano / Aneurisma Roto / Embolização Terapêutica Limite: Humans Idioma: En Revista: World Neurosurg Assunto da revista: NEUROCIRURGIA Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Aneurisma Intracraniano / Aneurisma Roto / Embolização Terapêutica Limite: Humans Idioma: En Revista: World Neurosurg Assunto da revista: NEUROCIRURGIA Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos