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North American Skull Base Society

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2025 Proffered Presentations

2025 Proffered Presentations

 

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S350: SUPRAORBITAL KEYHOLE APPROACH AS APPLIED TO CLIPPING OF RUPTURED INTRACRANIAL ANEURYSMS - LESSONS FROM A RESOURCE LIMITED SETTING
Christos Profyris, MD, AProf; Helen Joseph Hospital/ Netcare Milpark Hospital

This presentation explores the application of keyhole approaches as applied to ruptured intracranials aneurysms, with empasis on technical nuances. The author will present his personal series of ruptured aneurysms treated with a keyhole supraorbital approach . Twenty Nine ACOM aneurysms, 27 PCOM, 7 ICA Bifurcation, 2 Opthalmic and 3 MCA aneurysms were treated through a supraorbital keyhole approach. Fifty-one patients presented as WFNS Grades 1 to 3 and 17 patients presented as WFNS grades 4 to 5. Fourty-six (90%) WFNS 1-3 patients had a good outcome defined as a mRS Score of 2 or less. Six of 17 (35%) WFNS 4-5 patients had a good outcome. Fourty-Four patients were clipped within three days of rupture. All aneurysms within the series, including cases with intraoperative rupture, were succesfully clipped. The authors personal experiences and nuances of applying keyhole approaches to ruptured intracranial aneurysms will be emphasised. Surgical videos will be presented.

 

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