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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2016; 74(04): 314-319
DOI: 10.1590/0004-282X20150215
ARTICLE

Surgical clipping is still a good choice for the treatment of paraclinoid aneurysms

A clipagem cirúrgica é uma boa opção para o tratamento de aneurismas paraclinóideos
Felix Hendrik Pahl
1   IAMSPE,Hospital do Servidor Público Estadual de São Paulo,Departamento de Neurocirurgia,Sao PauloSP,Brazil;
2   Hospital Sirio Libanês,Departamento de Neurocirurgia,Sao PauloSP,Brazil;
3   DFV Neuro,São PauloSP,Brazil.
,
Matheus Fernandes de Oliveira
1   IAMSPE,Hospital do Servidor Público Estadual de São Paulo,Departamento de Neurocirurgia,Sao PauloSP,Brazil;
2   Hospital Sirio Libanês,Departamento de Neurocirurgia,Sao PauloSP,Brazil;
3   DFV Neuro,São PauloSP,Brazil.
,
Roger Schmidt Brock
2   Hospital Sirio Libanês,Departamento de Neurocirurgia,Sao PauloSP,Brazil;
3   DFV Neuro,São PauloSP,Brazil.
,
José Erasmo Dal Col Lucio
2   Hospital Sirio Libanês,Departamento de Neurocirurgia,Sao PauloSP,Brazil;
3   DFV Neuro,São PauloSP,Brazil.
,
José Marcus Rotta
1   IAMSPE,Hospital do Servidor Público Estadual de São Paulo,Departamento de Neurocirurgia,Sao PauloSP,Brazil;
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ABSTRACT

Paraclinoid aneurysms are lesions located adjacent to the clinoid and ophthalmic segments of the internal carotid artery. In recent years, flow diverter stents have been introduced as a better endovascular technique for treatment of these aneurysms.

Method From 2009 to 2014, a total of 43 paraclinoid aneurysms in 43 patients were surgically clipped. We retrospectively reviewed the records of these patients to analyze clinical outcomes.

Results Twenty-six aneurysms (60.5%) were ophthalmic artery aneurysms, while 17 were superior hypophyseal artery aneurysms (39.5%). The extradural approach to the clinoid process was used to clip these aneurysms. One hundred percent of aneurysms were clipped (complete exclusion in 100% on follow-up angiography). The length of follow-up ranged from 1 to 60 months (mean, 29.82 months).

Conclusion Surgical clipping continues to be a good option for the treatment of paraclinoid aneurysms.

RESUMO

Aneurismas paraclinóideos são lesões localizadas adjacentes aos segmentos clinóideos e oftálmicos da artéria carótia interna. Os stents desviadores de fluxo tem sido crescentemente aplicados com sucesso.

Métodos De 2009 a 2014, um total de 43 aneurismas paraclinóideos foram clipados em 43 pacientes. Analisamos retrospectivamente os dados dos pacientes e desfechos clínicos.

Resultados Vinte seis aneurismas (60,5%) foram de artéria oftálmica e 17 de artéria hipofisária superior (39,5%). O acesso extradural à clinóide foi utilizado para todos aneurismas. Cem por cento dos aneurismas foram clipados com oclusão de 100% na angiografia controle. O tempo de follow-up oscilou de 1 a 60 meses, com media de 29 meses.

Conclusão A clipagem cirúrgica é uma opção boa e segura para o tratamento de aneurismas paraclinóideos.

intracranial aneurysm - endovascular treatment - surgery
aneurisma intracraniano - tratamento endovascular - cirurgia


Publication History

Received: 17 August 2015

Accepted: 26 November 2015

Article published online:
06 September 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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