Fiche publication
Date publication
février 2016
Journal
Neuro-Chirurgie
Auteurs
Membres identifiés du Cancéropôle Est :
Pr PROUST François
Tous les auteurs :
Lejeune JP, Thines L, Proust F, Riegel B, Koussa M, Decoene C
Lien Pubmed
Résumé
Giant intracranial aneurysms are defined as greater than 25mm in diameter. They share the same surgical challenges and strategies as so-called complex aneurysms, sometimes smaller in size but presenting with similar complex anatomy. The surgical difficulties arise from the size of the sack, the presence of intraluminal thrombus, the thickness of the arterial wall, and the complexity of arterial branching on the neck. Preoperative imaging gathers complementary information from magnetic resonance imaging, computed tomographic angiography, and rotational catheter-based angiography with three-dimensional reconstruction including balloon-test occlusion. The therapeutic decision-making needs a multidisciplinary approach including endovascular, neurosurgical and anesthesiological expertises. The microsurgical treatment needs a step-by-step preoperative planning with anticipation of possible pitfalls and alternative strategies. Classical principles of aneurysm surgery have to be tailored to face the difficulties arising from the size of the sack and from the arterial wall calcifications.
Mots clés
Anévrismes complexes, Anévrismes géants, Complex aneurysms, Giant aneurysms, Microsurgery, Traitement microchirurgical
Référence
Neurochirurgie. 2016 02;62(1):30-7
