P053/29  Case series of 52 internal carotid artery aneurysm

IntroductionTreatment of Paraclinoid aneurysms remains a technical challenge because they occupy a tiny region packed with critical structures, including the C5 and C6 segments of ICA, their branches, and the optic apparatus, cavernous sinus.Aim of StudyCompare endovascular and microsurgical treatme...

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Published inJournal of neurointerventional surgery Vol. 15; no. Suppl 2; pp. A38 - A39
Main Authors Ehsan Mohammad Hosseini, Rasekhi, Ali Reza, Andalibi, Susan
Format Journal Article
LanguageEnglish
Published London BMJ Publishing Group LTD 01.09.2023
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Summary:IntroductionTreatment of Paraclinoid aneurysms remains a technical challenge because they occupy a tiny region packed with critical structures, including the C5 and C6 segments of ICA, their branches, and the optic apparatus, cavernous sinus.Aim of StudyCompare endovascular and microsurgical treatment of internal carotid artery aneurysmsMethodsIn the last 2.5 years, we treat 52 patients with ICA aneurysms.18 (34%) patients underwent endovascular treatment and in 34 patients (66%), microsurgical clipping was done.ResultsCTA images with 3D reformatting can very helpful in evaluating the association of aneurysm with ACP and the need for clinoidectomy during a microsurgical approach.In cases of microsurgical clipping, if clinoidectomy is essential for proximal control or aneurysm exposure, therefor cervical carotid must be prepared for proximal control.In our endovascular group, according to the aneurysm neck and aspect ratio, we treat a patient with primary coiling, stent assists coiling, and flow diverting stent.In Our case series, P.com is the most location for aneurysm formation and rupture.While more than 90% of P.com aneurysms are microsurgically treated, 70% of ophthalmic aneurysms are treated with an endovascular approach.In long-term follow-up, 90% of our patients have GOS 4 and 5, 2% have GOS 3 and 8% have GOS 1 or 2; that is not different in the endovascular or microsurgical group.ConclusionTreatment of ICA aneurysms requires precise anatomical evaluation and a multi-disciplinary approach.Both endovascular and microsurgical approaches are effective and have the same result.Disclosure of InterestNothing to disclose
ISSN:1759-8478
1759-8486
DOI:10.1136/jnis-2023-ESMINT.87