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Open surgical reconstruction of the internal carotid artery aneurysm at the base of the skull  Serguei Malikov, MD, PhD, Jean Marc Thomassin, MD, Pierre.

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Presentation on theme: "Open surgical reconstruction of the internal carotid artery aneurysm at the base of the skull  Serguei Malikov, MD, PhD, Jean Marc Thomassin, MD, Pierre."— Presentation transcript:

1 Open surgical reconstruction of the internal carotid artery aneurysm at the base of the skull 
Serguei Malikov, MD, PhD, Jean Marc Thomassin, MD, Pierre Edouard Magnan, MD, Grigol Keshelava, MD, Michel Bartoli, MD, Alain Branchereau, MD  Journal of Vascular Surgery  Volume 51, Issue 2, Pages (February 2010) DOI: /j.jvs Copyright © 2010 Society for Vascular Surgery Terms and Conditions

2 Fig 1 Drawing of the exposure of the ICA in the infra-temporal fossa after luxation of the mandibula. Insert: skin incision. ICA, internal carotid artery. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

3 Fig 2 PerI-operative view. Insert: specific retractor. Arrow: ICA. The loop is at the level of the opening of the petrous canal. Double arrow: Facial nerve. ICA, internal carotid artery. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

4 Fig 3 Division of the ICA in three segments: Segment 1, the bicarotid region. Segment 2, the retrostyloid region. Segment 3, the infratemporal fossa below the penetration into the base of the skull. The oblique line corresponds to the classic Blaisdell line11 between the tip of the mastoid process and the angle of the jaw. ICA, internal carotid artery. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

5 Fig 4 CT scan: with maximum intensity projection (left) and 3D reconstruction (right) of a fibromuscular dysplasic voluminous aneurysm at the contact of the base of the skull. This type of imaging allows to determine precisely the relationship between the aneurysm and the osseous elements. CT, Computed tomography. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

6 Fig 5 Picture of one of the patients of this series at the fifth post-operative day. Note the discrete palsy of the lower facial nerve without trouble on the higher territory. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

7 Fig 6 Postoperative CT-angiogram of a venous graft. The arrow on the right corresponds to the resection of the mastoid and the vaginal processes. CT, Computed tomography. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

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