经眉弓眶上锁孔入路夹闭前交通动脉动脉瘤

Clipping of anterior communicating artery aneurysm via supraorbital keyhole approach with eyebrow incision

目的探讨经眉弓眶上锁孔入路夹闭前交通动脉动脉瘤的策略和疗效。方法回顾性分析49例经眉弓眶上锁孔入路夹闭前交通动脉动脉瘤的病例资料,动脉瘤直径2～12 mm,根据A2开放平面选择手术侧别,全部动脉瘤术中获得良好显露。结果 49例前交通动脉动脉瘤均完成手术夹闭。术后切口皮下积液2例,眼睑上抬困难2例,经对症处理,症状消失或改善。随访1～37个月,未再发生动脉瘤破裂出血。结论经眉弓眶上锁孔入路是夹闭前交通动脉动脉瘤微创而安全有效的入路,以A2平面开放侧为手术入路侧更有利于动脉瘤暴露和夹闭。

Objective To summarize the strategies and outcomes of supraorbital keyhole craniotomy through an eyebrow incision for anterior communicating artery aneurysms. Methods The clinical data of 49 patients with anterior communicating artery aneurysms receiving supraorbital keyhole craniotomy through an eyebrow incision were analyzed retrospectively. Aneurysm diameter was 2-12 mm. All anterior communicating artery aneurysms were exposed and clipped successfully on the strategy that surgical approach based on the open A2 plane side. Results Forty-nine anterior communicating artery aneurysms were dipped successfully. Incision subcutaneous effusion occurred in 2 cases and eyelid open difficulty in 2 after surgery. The symptoms disappeared or improved after treatment. During follow-up period from 1 to 37 months, no aneurysm rupture recurred. Conclusions Supraorbital keyhole craniotomy through an eyebrow incision is minimally invasive and safe approach for anterior communicating artery aneurysms. The exposure and clipping of the aneurysms will be more favorable if surgical approach side is the same to the open A2 plane.