Strategies in intracavernous saccular aneurysms

  • G. Pendl
  • P. Vorkapic
  • B. Richling
  • W. T. Koos


Since the introduction of EC-IC bypass surgery in 1975 an additional method in the management of infraclinoid aneurysms has been available, as well as balloon catheter techniques in recent years and in addition to clipping, rhaphy, wrapping of the aneurysm and ligation of the internal carotid artery or trapping. We encountered 28 cases of infraclinoid aneurysms up until the end of 1985. Five patients were seen in severe condition on admission; they had no treatment and one of them eventually died. Direct clipping was possible in only 7 aneurysms regardless of their size, since dissection within the cavernous sinus even in large aneurysms was possible. Wrapping in broad-based large aneurysms was performed in 4 cases, since the clinical signs and symptoms as well as topographic anatomy did not lead us to expect an encroachment onto the cranial nerves. Endovascular techniques with a detachable balloon catheter were executed in 3 cases with an additional EC-IC bypass in two of these cases. Ligation of the internal carotid artery combined with an EC-IC bypass was achieved in 3 cases and in a further 2 cases only an EC-IC bypass was performed. In 2 cases trapping of the giant aneurysm by ligation of the internal carotid artery at the neck as well as distal to the aneurysms was performed. The results were satisfactory since the clinical signs and symptoms improved in most cases and no further deficits were encountered. Four patients died postoperatively. The various indications for the strategies applied are further discussed.


Internal Carotid Artery Internal Carotid Cavernous Sinus Intracranial Aneurysm Saccular Aneurysm 
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Copyright information

© Springer-Verlag/Wien 1987

Authors and Affiliations

  • G. Pendl
    • 1
  • P. Vorkapic
    • 1
  • B. Richling
    • 1
  • W. T. Koos
    • 1
  1. 1.Department of NeurosurgeryUniversity of Vienna Medical SchoolViennaAustria

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