polenovjournalРоссийский нейрохирургический журнал имени профессора А. Л. ПоленоваRussian Neurosurgical Journal named after Professor A. L. Polenov2071-2693Семинары, Конференции и Форумы10.56618/2071-2693_2023_15_3_145polenovjournal-296Research ArticleОБЗОРЫ ЛИТЕРАТУРЫ И КЛИНИЧЕСКИЕ СЛУЧАИREVIEWS OF LITERATURE AND CLINICAL CASESКлипирование аневризмы ствола базилярной артерии из keyhole-ретросигмовидного доступа, дополненного эндоскопической ассистенцией (клинический случай и обзор литературы)Basilar artery trunk aneurysm clipping via keyhole retrosigmoid approach with endoscopic assistance (clinical case and literature review)https://orcid.org/0000-0003-3283-9524ДжинджихадзеР. С.DzhindzhikhadzeR. S.

Джинджихадзе Реваз Семенович 

ул. Щепкина, 61/2, г. Москва, 129110 

Dzhindzhikhadze Revaz Semenovich 

61/2, Schepkina st., Moscow, 129110, Russia

КамбиевР. Л.KambievR. L.

Камбиев Ренат Леонидович

ул. Щепкина, 61/2, г. Москва, 129110 

Kambiev Renat Leonidovich 

61/2, Schepkina st., Moscow, 129110, Russia

https://orcid.org/0000-0001-7413-1968ПоляковА. В.PolyakovA. V.

Поляков Андрей Викторович 

ул. Щепкина, 61/2, г. Москва, 129110 

Polyakov Andrey Viktorovich 

61/2, Schepkina st., Moscow, 129110, Russia

https://orcid.org/0000-0002-9083-9293СтраховГ. Ю.StrakhovG. Yu.

Страхов Григорий Юрьевич

ул. Первомайская, 13, г. Тула, 300034 

Strakhov Grigoriy Yurievich 

13, Pervomayskaya st., Tula, 300034, Russia

https://orcid.org/0000-0002-0987-3436ЗайцевА. Д.ZaitsevA. D.

Зайцев Андрей Дмитриевич 

 ул. Щепкина, 61/2, г. Москва, 129110 

Zaitsev Andrew Dmitrievich 

61/2, Schepkina st., Moscow, 129110, Russia

https://orcid.org/0000-0003-1181-0036БогдановичИ. О.BogdanovichI. O.

Богданович Игорь Олегович 

ул. Щепкина, 61/2, г. Москва, 129110 

Bogdanovich Igor’ Olegovich 

61/2, Schepkina st., Moscow, 129110, Russia

ГБУЗ МО «Московский областной научно-исследовательский клинический институт им. М.Ф. Владимирского»РоссияMoscow Regional Research and Clinical InstituteRussian FederationГУЗ «Тульская городская клиническая больница скорой медицинской помощи им. Д.Я. Ваныкина»РоссияTula City Clinical Emergency Hospital n. a. D. Y. VanykinRussian Federation202319082023153145151Copyright © Джинджихадзе Р.С., Камбиев Р.Л., Поляков А.В., Страхов Г.Ю., Зайцев А.Д., Богданович И.О., 20232023Джинджихадзе Р.С., Камбиев Р.Л., Поляков А.В., Страхов Г.Ю., Зайцев А.Д., Богданович И.О.Dzhindzhikhadze R.S., Kambiev R.L., Polyakov A.V., Strakhov G.Y., Zaitsev A.D., Bogdanovich I.O.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://polenovjournal.elpub.ru/jour/article/view/296

Несмотря на увеличивающееся с каждым годом число эндоваскулярных вмешательств на аневризмах базилярной артерии, сохраняется определенная частота неблагоприятных исходов. С приходом в арсенал нейрохирургов эндоскопической ассистенции возможности открытых вмешательств на церебральных аневризмах расширились, позволяя минимизировать размеры доступов, не изменяя ширину микрохирургических коридоров.

Описано клиническое наблюдение успешного клипирования аневризмы ствола базилярной артерии с использованием ретросигмовидного доступа, дополненного эндоскопической ассистенцией.

Данный клинический случай демонстрирует возможность успешного клипирования аневризмы ствола базилярной артерии, не прибегая к широкому доступу, но с оптимальной визуализацией шейки и купола как до, так и после клипирования, а также с минимальными рисками повреждений важных парастволовых анатомических образований, что в конечном итоге позволяет достичь благоприятного результата. Минимально инвазивные доступы в сочетании с эндоскопической ассистенцией могут быть альтернативой как традиционным доступам, так и эндоваскулярной эмболизации.

Despite the increasing number of endovascular interventions for aneurysms of the basilar artery every year, a certain frequency of adverse outcomes remains. The possibilities of cerebral aneurysms surgery have expanded due to endoscopic assistance, which making it possible to minimize the size of approaches without changing the width of microsurgical corridors.

We present a case of successful clipping basilar artery trunk aneurysm via keyhole retrosigmoid approach supplemented with endoscopic assistance.

This clinical case demonstrates the possibility of successful clipping of a basilar artery trunk aneurysm without resorting to a wide approach, but with optimal visualization of the neck and dome before and after clipping. Keyhole approaches combined with endoscopic assistance can be an alternative to both traditional approaches and endovascular coiling.

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The authors declare that there are no conflicts of interest present.