Kim T S, Joo S P, Lee J K, Jung S, Kim J H, Kim S H, Kang S S, Yoon W
Department of Neurosurgery, Chonnam National University Medical School, Gwangju, Korea.
Minim Invasive Neurosurg. 2007 Apr;50(2):77-81. doi: 10.1055/s-2007-984380.
We present our experience with the neuronavigation system used for surgery of distal anterior cerebral artery (DACA) aneurysms.
Between 2001 and 2004, 12 patients with a DACA aneurysm were consecutively treated with direct clipping assisted by the neuronavigation system. We used the BrainLAB Vector Vision2 neuronavigation system (BrainLAB, Heimstetten, Germany). Seven out of 12 patients presented with subarachnoid hemorrhage. Aneurysms were located at distal A2 in 10 patients and distal A3 in two patients. The size of the aneurysms ranged from 3 to 10 mm.
There were no procedure-related complications or technical problems during application of the neuronavigation system. The registration accuracy ranged from 0.5 to 1.5 mm (mean: 0.88). The neuronavigation system provided real-time presentation of the DACA aneurysm, and allowed for identification of the DACA aneurysm in all patients. No surgical complications developed, and all 12 patients had a good recovery after direct clipping.
Although current neuronavigation systems are not available for all intracranial aneurysms, we believe that the DACA aneurysm is a good candidate for its use. The additional benefits of a small craniotomy and precise intraoperative orientation during surgery result in a minimally invasive aneurysm procedure.
我们介绍使用神经导航系统进行大脑前动脉远端（DACA）动脉瘤手术的经验。
2001年至2004年间，连续12例DACA动脉瘤患者在神经导航系统辅助下接受直接夹闭治疗。我们使用的是BrainLAB Vector Vision2神经导航系统（德国海姆斯泰滕的BrainLAB公司）。12例患者中有7例出现蛛网膜下腔出血。10例患者的动脉瘤位于A2段远端，2例位于A3段远端。动脉瘤大小在3至10毫米之间。
在应用神经导航系统过程中未出现与手术相关的并发症或技术问题。配准精度在0.5至1.5毫米之间（平均：0.88）。神经导航系统实时呈现了DACA动脉瘤，并使所有患者均能识别出DACA动脉瘤。未发生手术并发症，所有12例患者在直接夹闭术后恢复良好。
尽管目前并非所有颅内动脉瘤都可使用神经导航系统，但我们认为DACA动脉瘤是其适用的良好对象。小骨窗开颅以及手术中精确的术中定位所带来的额外益处，使得动脉瘤手术具有微创性。
