title: Microscopic anterior clinoidectomy with micro-rongeurs for a superior projecting paraclinoid internal carotid artery aneurysm: a technical note.
abstract: Anterior clinoidectomy is an essential manoeuvre for clipping paraclinoid internal carotid artery (ICA) aneurysms. However, the use of a drill or an ultrasonic bone curette in an anterior clinoidectomy involves a high risk for heat or mechanical injury of the superior projecting paraclinoid aneurysm. We report our technique for microscopic anterior clinoidectomy performed only using a micro-rongeur. The case of a superior projecting paraclinoid ICA aneurysm is presented. The anterior clinoid process was removed with our specially crafted micro-rongeurs, while we observed the extradural and intradural routes under a microscope. The aneurysm was completely clipped without any resulting neurological deficits. This technique can be safely used for paraclinoid ICA aneurysms, especially for superiorly projecting aneurysms.
authors: Department of Neurosurgery, Tokyo Metropolitan Tama Medical Center , Tokyo , Japan.
authors: Takahiro
authors: T
authors: Ota
authors: Tohru
authors: T
authors: Mizutani
mesh_terms: D002340:Carotid Artery Diseases / Q000473:pathology / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000473:pathology / Q000601:surgery*; D002533:Cerebral Angiography; D003399:Craniotomy / Q000295:instrumentation / Q000379:methods; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000473:pathology / Q000601:surgery*; D008866:Microsurgery / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000295:instrumentation / Q000379:methods*; D013100:Sphenoid Bone / Q000601:surgery*; D016896:Treatment Outcome