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CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2021; 40(03): e288-e293
DOI: 10.1055/s-0040-1719004
Technical Note | Nota Técnica

Minimally Invasive Mini-orbitozygomatic Approach for Clipping an Anterior Communicating Artery Aneurysm: Virtual Reality Surgical Planning

Abordagem mini-orbitozigomático minimamente invasiva para clipagem de um aneurisma da artéria comunicante anterior: planejamento cirúrgico de realidade virtual
Nicolás González Romo 
1   Department of Neurosurgery, Hospital Regional Rancagua, Rancagua, Chile
,
Franco Ravera Zunino 
1   Department of Neurosurgery, Hospital Regional Rancagua, Rancagua, Chile
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Abstract

Virtual reality (VR) has increasingly been implemented in neurosurgical practice. A patient with an unruptured anterior communicating artery (AcoA) aneurysm was referred to our institution. Imaging data from computed tomography angiography (CTA) was used to create a patient specific 3D model of vascular and skull base anatomy, and then processed to a VR compatible environment. Minimally invasive approaches (mini-pterional, supraorbital and mini-orbitozygomatic) were simulated and assessed for adequate vascular exposure in VR. Using an eyebrow approach, a mini-orbitozygomatic approach was performed, with clip exclusion of the aneurysm from the circulation. The step-by-step process of VR planning is outlined, and the advantages and disadvantages for the neurosurgeon of this technology are reviewed.

Resumo

A realidade virtual (RV) é uma ferramenta cada vez mais utilizada na prática neurocirúrgica. Apresentamos um caso de aneurisma da artéria comunicante anterior (AcoA) sem rompimento com planejamento cirúrgico por RV. Os dados da angiografia por tomografia computadorizada (ATC) DICOM foram usados para a criação de um modelo 3D da anatomia vascular e da base do crânio do paciente, seguido de análise em um ambiente compatível com RV. Abordagens minimamente invasivas (mini-pterional, supraorbital e mini-orbitozigomática) foram simuladas e avaliadas quanto à exposição vascular adequada na RV. Utilizando uma abordagem pela sobrancelha, foi realizada uma abordagem mini-orbitozigomática, com exclusão do aneurisma da circulação. O processo passo a passo do planejamento da RV foi descrito e foram revisadas as vantagens e desvantagens desta tecnologia.

Keywords

virtual reality - intracranial aneurysm - microsurgery - skull base

Palavras-chave

realidade virtual - aneurisma intracraniano - microcirurgia - base do crânio


Publication History

Received: 11 April 2020

Accepted: 24 August 2020

Article published online:
26 November 2020

© 2020. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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