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Uricchio M, Gupta S, Jakowenko N, Levito M, Vu N, Doucette J, Liew A, Papatheodorou S, Khawaja AM, Aglio LS, Aziz-Sultan MA, Zaidi H, Smith TR, Mekary RA. Computed Tomography Angiography Versus Digital Subtraction Angiography for Postclipping Aneurysm Obliteration Detection. Stroke 2019; 50:381-388. [DOI: 10.1161/strokeaha.118.023614] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Matthew Uricchio
- From the School of Pharmacy, MCPHS University, Boston, MA (M.U., N.J., M.L., N.V., J.D., R.A.M.)
| | - Saksham Gupta
- Computational Neurosciences Outcomes Center, Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (S.G., A.M.K., L.S.A., M.A.A.-S., H.Z., T.R.S., R.A.M.)
| | - Nicholas Jakowenko
- From the School of Pharmacy, MCPHS University, Boston, MA (M.U., N.J., M.L., N.V., J.D., R.A.M.)
| | - Marissa Levito
- From the School of Pharmacy, MCPHS University, Boston, MA (M.U., N.J., M.L., N.V., J.D., R.A.M.)
| | - Nguyen Vu
- From the School of Pharmacy, MCPHS University, Boston, MA (M.U., N.J., M.L., N.V., J.D., R.A.M.)
| | - Joanne Doucette
- From the School of Pharmacy, MCPHS University, Boston, MA (M.U., N.J., M.L., N.V., J.D., R.A.M.)
| | - Aaron Liew
- National University of Ireland, Galway (A.L.)
| | | | - Ayaz M. Khawaja
- Computational Neurosciences Outcomes Center, Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (S.G., A.M.K., L.S.A., M.A.A.-S., H.Z., T.R.S., R.A.M.)
| | - Linda S. Aglio
- Computational Neurosciences Outcomes Center, Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (S.G., A.M.K., L.S.A., M.A.A.-S., H.Z., T.R.S., R.A.M.)
- Department of Anesthesiology, Perioperative and Pain Management, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (L.S.A.)
| | - Mohammad Ali Aziz-Sultan
- Computational Neurosciences Outcomes Center, Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (S.G., A.M.K., L.S.A., M.A.A.-S., H.Z., T.R.S., R.A.M.)
| | - Hasan Zaidi
- Computational Neurosciences Outcomes Center, Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (S.G., A.M.K., L.S.A., M.A.A.-S., H.Z., T.R.S., R.A.M.)
| | - Timothy R. Smith
- Computational Neurosciences Outcomes Center, Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (S.G., A.M.K., L.S.A., M.A.A.-S., H.Z., T.R.S., R.A.M.)
| | - Rania A. Mekary
- From the School of Pharmacy, MCPHS University, Boston, MA (M.U., N.J., M.L., N.V., J.D., R.A.M.)
- Computational Neurosciences Outcomes Center, Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (S.G., A.M.K., L.S.A., M.A.A.-S., H.Z., T.R.S., R.A.M.)
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Distance Between the Falciform Ligament and Distal Dural Ring as a Surgical Landmark for the Treatment of Paraclinoid Aneurysms. World Neurosurg 2019; 124:e498-e502. [PMID: 30615993 DOI: 10.1016/j.wneu.2018.12.120] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 12/13/2018] [Accepted: 12/14/2018] [Indexed: 11/20/2022]
Abstract
OBJECTIVE It is difficult to completely comprehend the anatomy of the structures surrounding the paraclinoid region before aneurysm and tumor treatment therein. When treating paraclinoid aneurysms, it is important to determine the location of the aneurysm as intradural or extradural. Thus, accurate prediction of the position of the distal dural ring (DDR) is necessary. To this end, we focused on the falciform ligament (FL), which is easily visualized on images based on its anatomic features. We measured the distance between the FL and the DDR in patients undergoing paraclinoid aneurysm operations. METHODS Between January 2017 and July 2018, 15 patients who underwent clipping for paraclinoid aneurysm treatment were retrospectively identified. The distance between the FL and the DDR was measured using a microscale at the time of the operation. RESULTS The patients comprised 14 women and 1 man. The mean aneurysm diameter was 7.29 ± 2.21 mm and the median size was 6.5 mm. Eleven of the aneurysms were on the left and 4 were on the right side. The mean distance between the FL and the DDR was 3.50 ± 0.17 mm and the median distance was 3.50 mm. The distance between the FL and the DDR was almost the same across cases (3.5 mm). CONCLUSIONS The position of the FL can be easily predicted using preoperative three-dimensional computed tomography angiography based on its anatomic features. In this study, the DDR was located 3.5 mm proximal to the FL along the internal carotid artery. This information is useful for predicting the position of the DDR.
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