Simple anterior petroclinoid fold resection in the treatment of low-lying internal carotid-posterior communicating artery aneurysms

Background: We investigate cases of low-lying IC-PC artery aneurysms with the aim to demonstrate an easy and less laborious technique of APF resection in lieu of AC in cases involving difficult aneurysmal neck clipping. Methods: Among a total 117 IC-PC artery aneurysms, 15 low-lying IC-PC artery aneurysms(13 ruptured and 2 unruptured) were obliterated between January 1996 and December 2006. We retrospectively investigated patients who have been treated by simple resection of APF (APF group) compared with patients treated by AC (AC group) in the surgery of the communicating segment of the ICA aneurysms. Clinical, radiological, and operative data were analyzed; and the 2 groups were compared. Results: Among 15 cases, 7 cases were included in the AC group and 8 cases were included in the APF group. One case was treated by a combination of AC and APF resection simultaneously. There was no difference in the clinical outcome between the 2 groups. No operative complications were encountered in any patients treated by the simple APF resection. Conclusions: Simple APF resections improve the visualization of the proximal neck of aneurysms, allowing for accurate clip placement and also facilitating the use of proximal vascular control as an adjunct to low-lying IC-PC artery aneurysms surgery. (C) 2009 Elsevier Inc. All rights reserved.