Abstract:

Purpose: Intercranial arterial anevrism results in high morbidity and mortality if broken. Preventive treatment may be needed to prevent negative consequences. With this article, we aimed to discuss and share our first-term results in the light of our clinical principles and surgical approaches in the non-blooded intrakranial pre-circulation arterial anevrism (KICAA) surgery of a new clinic. Method: Between September 2020 and November 2022 patients diagnosed with KIKAA in our center and treated with micro-chirurgical clipling surgery were retrospective assessed. Intraoperatively, assistant devices such as video angiography and micro-Doppler ultrasound of sodium floresein integrated in the microscope were used. In the microscopic field, the second surgeon was actively experienced in the field with a third hand. We presented the various techniques and experiences we use to avoid complications with factual samples. We compared our surgical results with radiological and clinical data. Results: In our institution with the diagnosis of KICAA, a total of 40 patients, 44 aneurysms, 42 operations have been treated. The average age is 50 years (31/69 years), the follow-up period is 379 days (30/828 days). The patient's modified Rankin score (mRS) was assessed as mRS 3 associated with previously passed subaraknoid bleeding and postoperative changes were not detected, three patients were assessed as mRS 1 due to postoperative epileptic stroke, while 36 patients were mRS 0 at the end of the follow-up period. In two patients, a patient was re-operated after the detection of the rest in the aneurysm neck in the postoperative digital subtraction angiography, while the other patient was treated by an endovascular team. No patient has had an infarction associated with parent artery and perforate artery loss. 20 percent of patients experienced minor complications. The increase in the diversity and use of intraoperative assistant techniques may result in a decrease in the rate of complications of the second surgeon’s active participation in the operation in the field with a third hand. In addition, we are expected that the rate of complications will be reduced by the increase in the surgical experience in the vascular centers where the flow of the phenomenon is provided.

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