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• W2765892483 abstract "With multiple aneurysms diagnosed in 7% to 34% of patients with intracranial aneurysms,1 simultaneous treatment is an important justification for direct clipping. Multiple aneurysms around the circle of Willis can be exposed with 1 surgical corridor that spares patients a second craniotomy. In addition, small, broad-based aneurysms that are often difficult to treat endovascularly are easier to treat surgically. This video demonstrates simultaneous surgical clipping of incidental basilar apex and right middle cerebral artery (MCA) aneurysms in a 53-yr-old woman presenting with chronic headaches for 3 mo. Angiography revealed both aneurysms to be sessile and small, and with a history of 2 family members dying of aneurysm rupture, the patient opted for surgery. Institutional Review Board approval and consent was obtained for procedure. Initial clipping of the basilar aneurysm through a right orbitozygomatic craniotomy and wide Sylvian fissure split left some thinned aneurysmal tissue at the distal neck. With rotation of the clip blades inferiorly to incorporate this tissue, a dog ear was created at the proximal neck. An additional understacked clip was applied to this dog-ear remnant. Indocyanine green video angiography confirmed perforator patency. The sessile MCA aneurysm was softened with a temporary clip applied to the M1 segment, followed by direct clipping of the aneurysm. Postoperative angiography revealed no residual aneurysms and the patient recovered without deficits. Multiple intracranial aneurysms can be successfully managed with a single surgical stage that exposes all aneurysms, obviating the need for multiple procedures and/or craniotomies. Temporary clipping and aneurysm softening mitigate migration of the permanent clips during clip application.Watch now at https://academic.oup.com/ons/article-lookup/doi/10.1093/ons/opx227 {href:Single Video Player,role:media-player-id,content-type:play-in-place,position:float,orientation:portrait,label:Simultaneous Clipping of a Basilar Apex Aneurysm and Right Middle Cerebral Artery Aneurysm: 3-Dimensional Operative Video,caption:,object-id:[{pub-id-type:doi,id:},{pub-id-type:other,content-type:media-stream-id,id:1_0zpauu1c},{pub-id-type:other,content-type:media-source,id:Kaltura}]} Disclosure The authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article." @default.
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• W2765892483 date "2017-11-02" @default.
• W2765892483 modified "2023-09-27" @default.
• W2765892483 title "Simultaneous Clipping of a Basilar Apex Aneurysm and Right Middle Cerebral Artery Aneurysm: 3-Dimensional Operative Video" @default.
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• W2765892483 doi "https://doi.org/10.1093/ons/opx227" @default.
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