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  • Title: [The risk factors and preventions in keyhole minimally invasive approaches of intracranial aneurysms].
    Author: Qi ST, Shi XF, Feng WF, Xu YM, Huang LJ.
    Journal: Zhonghua Wai Ke Za Zhi; 2006 Jul 15; 44(14):982-4. PubMed ID: 17074214.
    Abstract:
    OBJECTIVE: To evaluate the risk factors and study the methods of prevention and treatment for the ruptures of aneurysms in keyhole minimally invasive approaches. METHODS: From 1999 to 2005, 115 cases of intracranial aneurysms were divided into 2 classes according to the risk factors of aneurysm rupture. Forty-three cases of lower risk underwent microsurgical procedures as keyhole approaches, including pterional approach in 20 cases, supraorbital approach in 18 cases, interhemispheric approach in 5 cases. Seventy-two cases, rest of microsurgical procedures, were performed as conventional craniotomy, including pterional approach in 31 cases, supraorbital approach in 11 cases, interhemispheric approach in 7 cases, pterional-supraorbital in 10 cases, pterional-interhemispheric in 6 cases, supraorbital-interhemispheric in 4 cases, pterional-supraorbital-interhemispheric in 3 cases. RESULTS: Six aneurysms leaked and 3 ruptured (rupture rate 7.0%) treated with keyhole approaches during operations. No one died by keyhole approaches. Eighteen aneurysms leaked and 9 ruptured (rupture rate 12.5%) treated with conventional approaches during operations. Two patients died by conventional approaches. CONCLUSIONS: Keyhole approaches as a time-saving, trauma-reducing procedure could improve the postoperative outcomes, but these approaches still exist probability of aneurysm rupture. It is possible that keyhole-bone flap becomes a limitation to deal with huge or ruptured aneurysms. And it is important to make a specially preventive strategy for aneurysm rupture.
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