Summary
A method is described in which we use a combined endovascular balloon-catheter technique and open microneurosurgical approach for clipping aneurysms of the proximal paraclinoidal intracranial segment of the internal carotid artery. By temporary occlusion of the cervical carotid artery and continuously retrograde sucking of blood from the distal vessel via a double-lumen balloon-catheter, clip application to large and critically located aneurysms is facilitated applying evacuation-decompression to the trapped arterial segment under intra-operative SEP-monitoring.
Similar content being viewed by others
References
Batjer HH, Samson DS (1990) Retrograde suction decompression of giant paraclinoidal aneurysms. Technical note. J Neurosurg 73: 305–306
Day AL (1990) Aneurysms of the ophthalmic segment. J Neurosurg 72: 677–691
Drake CG, Vanderlinden RG, Amacher AL (1968) Carotid-ophthalmic aneurysms. J Neurosurg 29: 24–31
Drake CG (1979) Giant intracranial aneurysms: experience with surgical treatment in 174 patients. Clin Neurosurg 26: 12–95
Fisher WS III (1990) Management of carotid ophthalmic aneurysms. Contemp Neurosurg 12 (19): 1–6
Fox JL (1988) Microsurgical treatment of ventral (paraclinoid) internal carotid artery aneurysms. Neurosurgery 22: 32–39
Hacke W, Zeumer H, Berg-Dammer E (1983) Monitoring of hemispheric or brainstem function with neurophysiologic methods during interventional neuroradiology. AJNR 4: 382–384
Gibo H, Lenkey C, Rhoton AL (1981) Microsurgical anatomy of the supraclinoid portion of the internal carotid artery. J Neurosurg 55: 560–574
Knosp E, Müller G, Perneczky A (1988) The paraclinoid carotid artery: anatomical aspects of a microneurosurgical approach. Neurosurgery 22: 896–901
Kobayashi S, Kyoshima K, Gibo H, Hegde SA, Takemae T, Sugita K (1989) Carotid cave aneurysms of the internal carotid artery. J Neurosurg 70: 216–221
Krieger D, Adams H-P, Albert FK, von Haken M, Hacke W (1992) Pure motor hemiparesis with stable somatosensory evoked potential monitoring during aneurysm surgery. Neurosurgery 31: 145–150
Linskey ME, Sekhar LN, Hecht ST (1992) Emergency embolectomy for embolic occlusion of the middle cerebral artery after internal carotid artery balloon test occlusion. J Neurosurg 77: 134–138
Nutik SL (1988) Ventral paraclinoid carotid aneurysms. J Neurosurg 69: 340–344
Pia HW (1978) Classification of aneurysms of the internal carotid system. Acta Neurochir (Wien) 40: 5–31
Tamaki N, Kim S, Ehara K, Asada M, Fujita K, Taomoto K, Matsumoto S (1991) Giant carotid-ophthalmic artery aneurysms: direct clipping utilizing the “trapping-evacuation” technique. J Neurosurg 74: 567–572
Yaşargil MG (1984) Microneurosurgery, Vol II. Thieme, Stuttgart
Yaşargil MG, Fox JL (1975) The microsurgical approach to intracranial aneurysms. Surg Neurol 3: 7–14
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Albert, F.K., Forsting, M., Aschoff, A. et al. Clipping of proximal paraclinoid aneurysms with support of the balloon-catheter “trapping-evacuation” technique. Acta neurochir 125, 138–141 (1993). https://doi.org/10.1007/BF01401841
Issue Date:
DOI: https://doi.org/10.1007/BF01401841