Published online Nov 6, 2020. doi: 10.12998/wjcc.v8.i21.5149
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
A hybrid operating room (Hybrid-OR) is a surgical space that combines a conventional operating room with advanced medical imaging devices.
Currently, there is no established evidence on the application of hybrid operating rooms in the treatment of large or giant intracranial carotid-ophthalmic aneurysms.
The purpose of this study was to explore and summarize the technical features and effectiveness of the application of a Hybrid-OR in treating major intracranial carotid-ophthalmic aneurysms.
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.
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).
The Hybrid-OR provides new ideas for the surgical clipping of large or giant intracranial carotid-ophthalmic aneurysms and effectively decreases the rate of intraoperative vessel stenosis and unsuccessful clipping.
Although the Hybrid-OR has received widespread attention for treating large or giant intracranial carotid-ophthalmic aneurysms, there are still no definitive conclusions. This study shows that the safety and ease of use make Hybrid-OR combined with microsurgery and intraoperative digital subtraction angiography systems an attractive modality for managing large or giant intracranial carotid-ophthalmic aneurysms.