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OPERATIVE NUANCES: STEP BY STEP (VIDEO SECTION)
Year : 2022  |  Volume : 70  |  Issue : 2  |  Page : 504--509

Hybrid Anterior Clinoidectomy in the Clipping of Paraclinoid Aneurysms: Technique, Utility and Case Illustration

Kuntal Kanti Das, Arun Kumar Srivastava, Kamlesh Singh Bhaisora, Balachandar, Awadhesh Kumar Jaiswal, Sanjay Behari 
 Department of Neurosurgery, SGPGIMS, Lucknow, Uttar Pradesh, India

Correspondence Address:
Dr. Kuntal Kanti Das
Department of Neurosurgery, SGPGIMS, Lucknow - 226 014, Uttar Pradesh
India

Background: Anterior clinoidectomy for aneurysm clipping is generally performed intradurally. Despite obvious advantages, accidental drill slippage or indirect damage from heat and bone dust remain major drawbacks. Objective: To demonstrate the surgical technique and utility of a combined extra- and intra-dural clinoidectomy in the clipping of dorsal wall paraclinoid internal carotid artery aneurysm. Material and Methods: A case of dorsal wall paraclinoid aneurysm which was stuck to the anterior clinoid process on preoperative angiogram is presented. The surgical technique is shown stepwise, and the intricacies of the technique are described. Results: The hybrid clinoidectomy allowed for proper delineation of the aneurysm, mobilization of the optic nerve and intracranial proximal control on the clinoidal segment by dint of “apparent” intracranial ICA lengthening. This allowed the aneurysm to be clipped successfully and the patient made an uneventful recovery. Conclusion: Hybrid clinoidectomy is a useful technique and must be learnt.


How to cite this article:
Das KK, Srivastava AK, Bhaisora KS, Balachandar, Jaiswal AK, Behari S. Hybrid Anterior Clinoidectomy in the Clipping of Paraclinoid Aneurysms: Technique, Utility and Case Illustration.Neurol India 2022;70:504-509


How to cite this URL:
Das KK, Srivastava AK, Bhaisora KS, Balachandar, Jaiswal AK, Behari S. Hybrid Anterior Clinoidectomy in the Clipping of Paraclinoid Aneurysms: Technique, Utility and Case Illustration. Neurol India [serial online] 2022 [cited 2022 Aug 11 ];70:504-509
Available from: https://www.neurologyindia.com/article.asp?issn=0028-3886;year=2022;volume=70;issue=2;spage=504;epage=509;aulast=Das;type=0