Avtor/Urednik		Dolenc, VV
Naslov		The direct surgical approach to intracavernous aneurysms
Tip		članek
Vir		In: Takakura K, Sasaki T, eds. Cerebrovascular surgery. 3rd international workshop on cerebrovascular surgery, Tokyo 1992: proceedings. Tokyo: CONVEX,
Leto izdaje		1994
Obseg		str. 29-37
Jezik		eng
Abstrakt		With tare exceptions, intracavernous internal carotied artery (ICA) aneuryams - in particular when they are large and cause mase effect - should be excluded from circulation. Different surgical techniques are employed in dealing with intracavernous ICA aneurysms depending on their location, size, shape and origin. The factor which most dictates the type of exclusion of the lesion is the size of the neck of the aneurysm. In cases where the diameter of the neck of the aneurysm is less than half the diameter of the ICA, it is possible to perform a "local" reconstruction of the ICA after exclusion of the aneurysm, sither by simple clipping or resoction of the aneurysm and suturing of the, ICA wall. When the orifice of the aneurysm encompasses more than half the circumferenca of the ICA, it is rarely possible to occlude the neck of the aneurysm without creating significant stenosis of the ICA. To avoid the postoperative occlusion of the ICA in broad-neck aneurysms, a "direct" reconstruction of the ICA - after resection of the aneurysm and the diseased ICA wall - was introduced. In cases where the aneurysm represents a fusiform dilatation of the ICA in the cavernous sinus (CS) on a segment longer than half a centimeter, a "complete" reconstruction of the ICA is necessary after resection of the diseases segment in quistion. The complete reconstruction of the ICA is performed by grafting the ICA from the petrous segment of the ICA proximally onto the (paraclinoid) extradural segment of even distally onto the phthalmic sagment of the ICA. Venous grafts have lately bean substituted by arterial grafts. Neurological deficite caused by intracavernous ICA aneurysms are presented, as well as the final outcome following the direct surgical treatment of these aneurysms. Abstract truncated at 3200 characters.
Deskriptorji		CEREBRAL ANEURYSM CAVERNOUS SINUS CAROTID ARTERY, INTERNAL TREATMENT OUTCOME