Techniques of intracranial aneurysm wall biopsy

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http://hdl.handle.net/10138/303942

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Muhammad , S & Niemelä , M 2019 , ' Techniques of intracranial aneurysm wall biopsy ' , Interdisciplinary neurosurgery , vol. 17 , pp. 10-11 . https://doi.org/10.1016/j.inat.2019.01.022

Title: Techniques of intracranial aneurysm wall biopsy
Author: Muhammad, Sajjad; Niemelä, Mika
Contributor: University of Helsinki, Clinicum
University of Helsinki, Department of Neurosciences
Date: 2019-09
Language: eng
Number of pages: 2
Belongs to series: Interdisciplinary neurosurgery
ISSN: 2214-7519
URI: http://hdl.handle.net/10138/303942
Abstract: Current treatment modalities for the treatment of intracranial aneurysms including surgical clipping and endovascular coiling are invasive and have some treatment risks. Since not all aneurysms rupture, it is critical to detect rupture prone aneurysms. Molecular and cellular analysis of aneurysm tissue may provide understanding about pathobiology of aneurysm rupture and to develop imaging techniques to detect rupture prone aneurysms. For more than 15-years we have collected samples to identify pathological processes in the aneurysm wall itself predisposing to rupture. This has opened a new field of research leading to novel findings and multiple scientific publications. Surgical techniques of sampling the aneurysm dome have never been demonstrated so therefore many neurosurgeons are reluctant to take biopsies for research. Now we demonstrate with an intraoperative video the techniques of sampling the aneurysm dome after clipping an incidental right-sided 5-mm unruptured MCA aneurysm in a 58-year-old hypertensive male with past long history of smoking through lateral supraorbital approach. A focused opening of the Sylvian fissure was performed and the aneurysm was clipped using standard techniques. After placement of a titanium clip, ICG and Doppler were performed to ensure patency of both M2 vessels and the aneurysm was punctured. The aneurysm dome was then held in place with the suction and cut with microscissors for research purposes. Another titanium clip was placed (Video 1). The clinical course was uneventful. This technical note will help young neurosurgeons to contribute actively in aneurysm research also potentially to find non-invasive methods to prevent aneurysms from rupture.
Subject: Intracranial aneurysm biopsy
Video demonstration
Technical aspects
Aneurysm wall research
GROWTH-FACTOR
RUPTURE
DEGENERATION
CELLS
3126 Surgery, anesthesiology, intensive care, radiology
3112 Neurosciences
3124 Neurology and psychiatry
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