Optic Foraminotomy versus Anterior Clinoidectomy for Small Superior-Projecting Paraclinoid Aneurysms: Visual and Angiographic Outcome Evaluation

Authors

Sabino Luzzi, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy; Neurosurgery Unit, Department of Surgical Sciences, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. Electronic address: sabino.luzzi@unipv.it.
Alice Giotta Lucifero, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.
Matias Baldoncini, Department of Neurological Surgery, San Fernando Hospital, Buenos Aires, Argentina; Laboratory of Microsurgical Neuroanatomy, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina.
Alvaro Campero, Department of Neurological Surgery, Padilla Hospital, Tucumán, Argentina.
Renato Galzio, Neurosurgery Unit, Maria Cecilia Hospital, Cotignola, Italy.
Michael T. Lawton, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA.Follow

Document Type

Article

Abstract

INTRODUCTION: Optic foraminotomy (OF) has been recently proposed as an alternative to anterior clinoidectomy (AC) for selected types of paraclinoid aneurysms. In this study, OF and AC were compared for small superior-projecting paraclinoid aneurysms assuming visual and angiographic results as outcome measures. Indications for OF are also discussed. METHODS: Data of patients who underwent surgery for a paraclinoid aneurysm in the last 10 years were collected across 3 tertiary hospitals. Small to regular-size and superior projecting aneurysms were sorted. Multiple and complex aneurysms were excluded. Records of patients who went through OF were compared with those of patients who underwent AC. Neurologic outcome was reported as a modified Rankin Scale. Aneurysm complete occlusion rate and rate of approach-related worsened vision were selected as outcome measures of efficacy and safety, respectively, of the OF versus AC. Unpaired t test and χ test were used for numerical and categorical variables, respectively. A P value less than 0.05 was considered statistically significant. RESULTS: OF and AC groups involved 18 and 25 patients, respectively. Complication rate, overall neurologic outcome, rate of approach-related worsened vision, and complete occlusion rate did not differ between the groups. The average follow-up was 51 ± 34 and 60 ± 41 months in the OF and AC groups, respectively. CONCLUSIONS: Compared to AC, OF did not show either a higher rate of approach-related worsened vision or a lower aneurysm complete occlusion rate. OF can be considered a valid alternative to the AC for small superior-projecting dorsal ICA wall paraclinoid aneurysms.

Medical Subject Headings

Humans; Intracranial Aneurysm (diagnostic imaging, surgery, complications); Foraminotomy; Angiography; Treatment Outcome; Outcome Assessment, Health Care; Carotid Artery, Internal (surgery)

Publication Date

2-1-2023

Publication Title

World neurosurgery

E-ISSN

1878-8769

Volume

170

First Page

e612

Last Page

e621

PubMed ID

36410704

Digital Object Identifier (DOI)

10.1016/j.wneu.2022.11.081

Recommended Citation

Luzzi, Sabino; Giotta Lucifero, Alice; Baldoncini, Matias; Campero, Alvaro; Galzio, Renato; and Lawton, Michael T., "Optic Foraminotomy versus Anterior Clinoidectomy for Small Superior-Projecting Paraclinoid Aneurysms: Visual and Angiographic Outcome Evaluation" (2023). Neurosurgery. 1821.
https://scholar.barrowneuro.org/neurosurgery/1821