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Surgery for giant aneurysms – clip or bypass
In this key lecture, Dr. Vajkoczy focuses on surgery for giant aneurysms, and more specifically when to use a direct or an indirect approach.
1. Background of treatment of giant aneurysms
2. Review of giant aneurysm analysis
3. Surgical treatment vs. Endovascular treatment
4. Clinical examples
5. Skull base approach for giant aneurysms
6. Selection of approaches for giant aneurysm
7. Philosophy of giant aneurysm
8. Direct techniques for giant aneurysms
9. End-to-end anastomosis
10. Indirect techniques
11. Balloon occlusion test
12. PICA aneurysm
13. Clinical cases
14. Trapping of aneurysm
15. Side-to-side bypass
16. PICA-PICA bypass clinical case
17. Complex MCA aneurysm
18. IC giant aneurysm clinical case
19. Conclusion
P Vajkoczy
Lecture
3 years ago
528 views
47 likes
0 comments
23:41
Surgery for giant aneurysms – clip or bypass
In this key lecture, Dr. Vajkoczy focuses on surgery for giant aneurysms, and more specifically when to use a direct or an indirect approach.
1. Background of treatment of giant aneurysms
2. Review of giant aneurysm analysis
3. Surgical treatment vs. Endovascular treatment
4. Clinical examples
5. Skull base approach for giant aneurysms
6. Selection of approaches for giant aneurysm
7. Philosophy of giant aneurysm
8. Direct techniques for giant aneurysms
9. End-to-end anastomosis
10. Indirect techniques
11. Balloon occlusion test
12. PICA aneurysm
13. Clinical cases
14. Trapping of aneurysm
15. Side-to-side bypass
16. PICA-PICA bypass clinical case
17. Complex MCA aneurysm
18. IC giant aneurysm clinical case
19. Conclusion
Endoscopic endonasal approach to pituitary adenomas
The endoscopic endonasal approach is a continuously evolving speciality of modern neurosurgery, which requires precise anatomical knowledge, technical skills and integrated appreciation of the pathology to be treated.
This technique is a minimally invasive approach that allows the surgeon to deal with several diseases, especially entire skull base obviating brain retraction. The endoscopic endonasal approach offers some advantages arising from the use of the endoscope itself: a superior close-up view of the relevant anatomy and an enlarged working angle with an increased panoramic vision within the surgical area. Indeed, it offers the opportunity to safely and effectively visualize the surgical field, which as a result provides a corridor through the nasal cavity to reach the brain with its neurovascular structures.
Most pituitary adenomas can be managed and removed through a standard transsphenoidal approach either microscopically or endoscopically. More recently, the introduction of the endoscope in the extended endoscopic endonasal approach has made this technique more popular, and today this technique can be considered suitable for the removal of lesions extending beyond the sellar area such as parasellar, suprasellar and/or retrosellar spaces.
We have been using the endoscopic endonasal technique since 1997 on more than 1000 patients, aiming to remove first sellar lesions and more recently skull base lesions applying the so-called extended endonasal approach.
We report our experience through a step-by-step depiction of the surgical techniques to access the different compartments, detailing the anatomy as seen from the endonasal perspective, focusing on dangerous landmarks, describing possible complications and techniques used to manage this kind of lesions.
D Solari
Lecture
7 years ago
678 views
6 likes
0 comments
19:31
Endoscopic endonasal approach to pituitary adenomas
The endoscopic endonasal approach is a continuously evolving speciality of modern neurosurgery, which requires precise anatomical knowledge, technical skills and integrated appreciation of the pathology to be treated.
This technique is a minimally invasive approach that allows the surgeon to deal with several diseases, especially entire skull base obviating brain retraction. The endoscopic endonasal approach offers some advantages arising from the use of the endoscope itself: a superior close-up view of the relevant anatomy and an enlarged working angle with an increased panoramic vision within the surgical area. Indeed, it offers the opportunity to safely and effectively visualize the surgical field, which as a result provides a corridor through the nasal cavity to reach the brain with its neurovascular structures.
Most pituitary adenomas can be managed and removed through a standard transsphenoidal approach either microscopically or endoscopically. More recently, the introduction of the endoscope in the extended endoscopic endonasal approach has made this technique more popular, and today this technique can be considered suitable for the removal of lesions extending beyond the sellar area such as parasellar, suprasellar and/or retrosellar spaces.
We have been using the endoscopic endonasal technique since 1997 on more than 1000 patients, aiming to remove first sellar lesions and more recently skull base lesions applying the so-called extended endonasal approach.
We report our experience through a step-by-step depiction of the surgical techniques to access the different compartments, detailing the anatomy as seen from the endonasal perspective, focusing on dangerous landmarks, describing possible complications and techniques used to manage this kind of lesions.