Miyoshi Norio, Shinomiya Kazutaka, Tanaka Takanori, Kitaguchi Miwa, Yoshisako Yuta, Kataoka Toru, Nagahata Toshihiro, Uranishi Ryunosuke
Department of Neurosurgery, Bellland General Hospital.
No Shinkei Geka. 2020 Apr;48(4):329-333. doi: 10.11477/mf.1436204186.
Neck clipping of basilar trunk aneurysms, particularly those of a large size, is challenging because of its location. Here, we report a case of a basilar artery aneurysm successfully treated with neck clipping using rapid ventricular pacing(RVP). A 67-year-old woman was referred to our hospital for treatment of a large basilar artery aneurysm. Although coiling was considered, we performed neck clipping of this aneurysm because of the expected radical therapeutic effect. The patient was positioned in the right park-bench position, and right suboccipital craniotomy was performed. The aneurysm was mainly approached via the right supracerebellar route. RVP softened the aneurysm for easy dissection and insertion of multiple clips. The postoperative course was uneventful, and she was discharged 1 week later without neurological deficits. RVP should be considered for the treatment of complex aneurysms as adjunctive techniques.
