Endovascular assisted vertebrobasilar junction aneurysm clipping in a hybrid operation room. Case report

Introduction: We present a case of a 60-year-old female that underwent surgery for clipping a right vertebrobasilar junction aneurysm (VBJA) in a hybrid operation room.Research question: Does the retrograde suction technique with a proximal balloon is safe and effective as an adjuvant technique in s...

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Detalles Bibliográficos
Autores: Vilalta, Àlex de, López, Pablo, Sanmillan Blasco, Jose Luis, Miquel, Maria Angels de, Barranco, Roger, Gabarrós, Andreu
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/224641
Acceso en línea:https://hdl.handle.net/2445/224641
Access Level:acceso abierto
Palabra clave:Cirurgia cranial
Punció arterial
Hemorràgia subaracnoïdal
Skull surgery
Arterial puncture
Subarachnoid hemorrhage
Descripción
Sumario:Introduction: We present a case of a 60-year-old female that underwent surgery for clipping a right vertebrobasilar junction aneurysm (VBJA) in a hybrid operation room.Research question: Does the retrograde suction technique with a proximal balloon is safe and effective as an adjuvant technique in surgery of VBJA?Material and methods: After an extended retrosigmoid approach was performed, a 6F Neuron catheter with an intermediate multipurpose catheter were navigated to the right vertebral artery (VA) through a 6-French sheath, which caused a severe catheter-induced vasospasm in the right VA. The aneurysm was then deflated and clipped. After the withdrawal of the catheter the vasospasm was resolved.Results: The patient had a good recovery, with VI cranial nerve palsy and mild dysphagia due to mild right vocal cord palsy, both improving at 1-month follow-up and fully recovered at 6-month follow-up. Discussion and conclusion: The combination of endovascular procedures and microsurgery at the same hybrid operation room in that case resulted in a safe and effective technique. It is an interesting tool that could help neurosurgeons deal with certain selected cases of VBJA. Intraoperative angiography offers the possibility to reposition a misplaced clip in the same surgery. Good collaboration between interventional neuroradiologists and vascular neurosurgeons helps in achieving good results in such difficult cases.