Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2020; 8(21): 5149-5158
Published online Nov 6, 2020. doi: 10.12998/wjcc.v8.i21.5149
Application of hybrid operating rooms for clipping large or giant intracranial carotid-ophthalmic aneurysms
Nai Zhang, Wen-Qiang Xin
Nai Zhang, Wen-Qiang Xin, Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin 300052, China
Author contributions: Xin WQ and Zhang N designed the study, acquired the data, drafted the article, analyzed and interpreted the data, and revised the article critically for important intellectual content together; all the authors approved the version to be published.
Supported by the Tianjin Science and Technology Projects in Key Areas of Traditional Chinese Medicine, No. 2018001.
Institutional review board statement: This study, involving human participants, was reviewed and approved by the ethics committee of Tianjin Medical University General Hospital, and informed written consent was obtained from the participant for the publication of this manuscript. For the participant who was under the age of 16, written informed consent was obtained from the guardians of the participant for the publication of this manuscript.
Informed consent statement: All patients gave informed consent to the study.
Conflict-of-interest statement: All authors declare no conflicts of interest related to this study.
Data sharing statement: The datasets acquired during the current study are available from the corresponding author based on reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Wen-Qiang Xin, MD, Doctor, Surgeon, Department of Neurosurgery, Tianjin Medical University General Hospital, No. 154 Anshan Road, Heping District, Tianjin 300052, China. xinwenqiangdr@126.com
Received: July 21, 2020
Peer-review started: July 14, 2020
First decision: August 8, 2020
Revised: August 12, 2020
Accepted: September 18, 2020
Article in press: September 18, 2020
Published online: November 6, 2020
Processing time: 108 Days and 2.5 Hours
Abstract
BACKGROUND

A hybrid operating room (Hybrid-OR) is a surgical theatre that combines a conventional operating room with advanced medical imaging devices. There are still plenty of limitations when endovascular treatment or microsurgical treatment is used individually to treat large or giant carotid-ophthalmic aneurysms.

AIM

To explore and summarize the technical features and effectiveness of the application of a Hybrid-OR in managing major intracranial carotid-ophthalmic aneurysms.

METHODS

The Department of Neurosurgery treated 12 cases of large or giant intracranial carotid-ophthalmic aneurysms between March 2013 and December 2019 in a Hybrid-OR. All cases were treated with clipping and parent vessel reconstruction.

RESULTS

With the assistance of the Hybrid-OR, the rate of incomplete intraoperative aneurysm clipping decreased from 25% (3/12) to 0%, while the rate of vessel stenosis decreased from 16.7% (2/12) to 8.35% (1/12). In terms of thromboembolic events, ischemic infarction complication occurred in only one patient, and none of the patients experienced embolic infarction complications. All 12 patients were followed for an average of 3 years, and no aneurysms recurred. The postoperative recovery was evaluated with the modified Rankin Scale (mRS): 11 patients showed no symptoms (mRS = 0), 1 patient showed slight disability (mRS 1-2), and none of the patients had severe disability (mRS = 5) or died (mRS = 6).

CONCLUSION

The Hybrid-OR provides new ideas for the surgical clipping of large or giant intracranial carotid-ophthalmic aneurysms and decreases the rate of intraoperative vessel stenosis and unsuccessful clipping.

Keywords: Balloon; Microsurgical clipping; Hybrid operating room; Large or giant carotid-ophthalmic aneurysm

Core Tip: We retrospectively analyzed 12 cases of large or giant intracranial carotid-ophthalmic aneurysms treated in a hybrid operating room (Hybrid-OR) at our hospital. We aimed to explore and summarize the technical features and effectiveness of a Hybrid-OR in treating major intracranial carotid-ophthalmic aneurysms. The Hybrid-OR provides new ideas for the surgical clipping of large or giant intracranial carotid-ophthalmic aneurysms and decreases the rate of intraoperative vessel stenosis and unsuccessful clipping.