• Br J Neurosurg · Aug 2013

    Case Reports

    Microscopic anterior clinoidectomy with micro-rongeurs for a superior projecting paraclinoid internal carotid artery aneurysm: a technical note.

    • Takahiro Ota and Tohru Mizutani.
    • Department of Neurosurgery, Tokyo Metropolitan Tama Medical Center , Tokyo , Japan.
    • Br J Neurosurg. 2013 Aug 1;27(4):540-2.

    AbstractAnterior clinoidectomy is an essential manoeuvre for clipping paraclinoid internal carotid artery (ICA) aneurysms. However, the use of a drill or an ultrasonic bone curette in an anterior clinoidectomy involves a high risk for heat or mechanical injury of the superior projecting paraclinoid aneurysm. We report our technique for microscopic anterior clinoidectomy performed only using a micro-rongeur. The case of a superior projecting paraclinoid ICA aneurysm is presented. The anterior clinoid process was removed with our specially crafted micro-rongeurs, while we observed the extradural and intradural routes under a microscope. The aneurysm was completely clipped without any resulting neurological deficits. This technique can be safely used for paraclinoid ICA aneurysms, especially for superiorly projecting aneurysms.

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