Microscopic anterior clinoidectomy with micro-rongeurs for a superior projecting paraclinoid internal carotid artery aneurysm: a technical note

Abstract

Anterior clinoidectomy is an essential manoeuvre for clipping paraclinoid internal carotid artery (ICA) aneurysms. However, the use of a drill or an ultrasonic bone curette in an anterior clinoidectomy involves a high risk for heat or mechanical injury of the superior projecting paraclinoid aneurysm. We report our technique for microscopic anterior clinoidectomy performed only using a micro-rongeur.

The case of a superior projecting paraclinoid ICA aneurysm is presented. The anterior clinoid process was removed with our specially crafted micro-rongeurs, while we observed the extradural and intradural routes under a microscope. The aneurysm was completely clipped without any resulting neurological deficits.

This technique can be safely used for paraclinoid ICA aneurysms, especially for superiorly projecting aneurysms.

Keywords::

• anterior clinoidectomy
• clipping
• micro-rongeur
• paraclinoid aneurysm
• superiorly projecting

Declaration of interest: The authors report no declarations of interest. The authors alone are responsible for the content and writing of the paper.