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| Name | Superior Hypophyseal Aneurysm Clipping: Part 2 |
| Video Uploader | Video From NEUROSURGERY Journal |
| Upload Date | This Video Uploaded At 05-01-2015 14:24:30 |
| Video Discription | Anterior clinoidectomy is a gateway to the complex anatomy of the clinoidal segment of the internal carotid artery (ICA), proximal branch arteries, the distal dural ring, and the necks of paraclinoid aneurysms. After anterior clinoidectomy, the cavernous sinus is controlled with fibrin glue injection, the dural ring is incised circumferentially, the optic strut is drilled further, and the ICA is released from its dural attachments. These maneuvers access the aneurysm neck for clipping. This 3-D video illustrates the microsurgical clipping of a large left superior hypophyseal artery (SHA) aneurysm in a 56-year-old woman. Part 1 demonstrates anterior clinoidectomy, and Part 2 demonstrates dural ring dissection and aneurysm clipping. Additionally, 3-D cadaveric specimens illustrate surgical anatomy and emphasize the need for cadaveric dissection. The medial projection of SHA aneurysms away from the surgical trajectory interposes the ICA between the neurosurgeon and the aneurysm neck, making it difficult to view the pathology completely and requiring the use of tandem, angled fenestrated clips to ensure adequate closing forces of the blades. The complex morphology of inflow and outflow arteries requires multiple clips that reconstruct the curves of the parent artery, as in this case. Microsurgical clipping of SHA aneurysms is challenging because the pathology is complex, clip application is incompletely visualized in the dark medial spaces, and the optic nerve is an unforgiving obstacle. This video is intended to increase familiarity with SHA aneurysms because endovascular advances are decreasing the surgical indications for these lesions and diminishing our collective proficiency in managing them with open microsurgery. |
| Category | Science & Technology |
| Tags | Science & Technology Download MP4 | Science & Technology Download MP3 | Science & Technology Download MP4 360p | Science & Technology Download MP4 480p | Science & Technology Download MP4 720p | Science & Technology Download MP4 1080p |
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