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Endoscope-Assisted Microneurosurgery for Intracranial Aneurysms: Operative Technique, Reliability, and Feasibility Based on 14 Years of Personal Experience

  • Massimo Gallieni
  • Mattia Del Maestro
  • Sabino Luzzi
  • Donatella Trovarelli
  • Alessandro Ricci
  • Renato Galzio
Conference paper
Part of the Acta Neurochirurgica Supplement book series (NEUROCHIRURGICA, volume 129)

Abstract

Endoscope-assisted microneurosurgery (EAM) combines endoscopic and microsurgical techniques for the treatment of deeply located intracranial lesions. During aneurysm surgery, endoscopic assistance may aid in the visualization of perforating arteries, especially when minimally invasive approaches are used. Between 2002 and 2015, a total of 183 patients with 208 intracranial aneurysms were surgically treated in our department. EAM was performed in 191 procedures. In all, 159 aneurysms were located in the anterior circulation and 49 in the posterior circulation. Of these, 135 aneurysms were ruptured. Lesions were exposed through standard skull base microsurgical approaches. The endoscope was employed during three steps: initial inspection, true operative time, and final inspection. Complications directly related to endoscopic procedures were rare; no surgical mortality was observed in this series. A retrospective analysis of each procedure showed that the usefulness of EAM depended on the anatomical location and size of the lesions. Its advantages were especially evident when dedicated scopes and holders were used.

Keywords

Intracranial aneurysms Sub-arachnoid hemorrhage Clip ligation Microneurosurgery Endoscope-assisted microsurgery 

Notes

Conflict of Interest Statement

The authors declare that they have no conflict of interest.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Massimo Gallieni
    • 1
  • Mattia Del Maestro
    • 1
  • Sabino Luzzi
    • 2
  • Donatella Trovarelli
    • 3
  • Alessandro Ricci
    • 2
  • Renato Galzio
    • 1
    • 2
  1. 1.Department of Life, Health and Environmental Sciences (MESVA)University of L’AquilaL’AquilaItaly
  2. 2.Department of NeurosurgerySan Salvatore City HospitalL’AquilaItaly
  3. 3.Department of AnesthesiologySan Salvatore City HospitalL’AquilaItaly

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