Department of Neurosurgery, Geisinger Health System, Danville, Pennsylvania.
Research Institute of Neurointervention, Paracelsus Medical University, Salzburg, Austria.
Oper Neurosurg (Hagerstown). 2019 Oct 1;17(4):348-353. doi: 10.1093/ons/opy389.
The minimally invasive parafascicular approach provides a surgical corridor to reach deep lesions with minimal impact on the surrounding brain tissue.
To evaluate the safety and efficacy of this approach utilizing the image-guided tubular BrainPath system (NICO Corp, Indianapolis, Indiana) for the resection of deep and subcortical supratentorial cerebral cavernous malformations (CCMs).
We performed a retrospective analysis of patients who presented with subcortical CCMs treated with the BrainPath system. Patient demographics, clinical presentation, procedural complications, and clinical and imaging follow-up information were assessed.
Six patients were identified between December 2014 and November 2017 at a large volume academic institution in the United States. There were 3 males and 3 female patients with a median age of 25 yr. Locations included frontal, temporal, and parietal lobes. In selected cases, the fiber-sparing trajectory imposed a longer approach than the closest distance to the brain surface. Except for 1 patient who suffered from surgical wound dehiscence, there were no operative complications in any of the cases. All patients remained neurologically stable postoperatively with a mean follow-up of 20 moh.
This small series suggests that the use of a minimally invasive surgical approach to CCMs utilizing the image-guided parafascicular tubular BrainPath system is feasible, safe, and effective.
微创的旁正中入路为到达深部病变提供了手术通道，对周围脑组织的影响最小。
利用图像引导的管状 BrainPath 系统（NICO 公司，印第安纳州印第安纳波利斯）评估这种方法治疗深部和皮质下幕上脑海绵状血管畸形（CCM）的安全性和有效性。
我们对在一家大型学术机构就诊的接受 BrainPath 系统治疗的皮质下 CCM 患者进行了回顾性分析。评估了患者的人口统计学资料、临床表现、手术并发症以及临床和影像学随访信息。
2014 年 12 月至 2017 年 11 月期间，在美国一家大型医疗机构共确定了 6 名患者。3 名男性，3 名女性，中位年龄 25 岁。病变部位包括额叶、颞叶和顶叶。在选择的病例中，保留纤维的轨迹比到脑表面的最短距离需要更长的入路。除 1 例患者发生手术切口裂开外，所有病例均无手术并发症。所有患者术后神经功能均保持稳定，平均随访 20 个月。
本小系列研究表明，使用图像引导的旁正中管状 BrainPath 系统对 CCM 进行微创手术是可行、安全且有效的。
