Muirhead, WR;
Layard Horsfall, H;
Khan, DZ;
Koh, C;
Grover, PJ;
Toma, AK;
Castanho, P;
... Murphy, M; + view all
(2022)
Microsurgery for intracranial aneurysms: A qualitative survey on technical challenges and technological solutions.
Frontiers in Surgery
, 9
, Article 957450. 10.3389/fsurg.2022.957450.
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Abstract
INTRODUCTION: Microsurgery for the clipping of intracranial aneurysms remains a technically challenging and high-risk area of neurosurgery. We aimed to describe the technical challenges of aneurysm surgery, and the scope for technological innovations to overcome these barriers from the perspective of practising neurovascular surgeons. MATERIALS AND METHODS: Consultant neurovascular surgeons and members of the British Neurovascular Group (BNVG) were electronically invited to participate in an online survey regarding surgery for both ruptured and unruptured aneurysms. The free text survey asked three questions: what do they consider to be the principal technical barriers to aneurysm clipping? What technological advances have previously contributed to improving the safety and efficacy of aneurysm clipping? What technological advances do they anticipate improving the safety and efficacy of aneurysm clipping in the future? A qualitative synthesis of responses was performed using multi-rater emergent thematic analysis. RESULTS: The most significant reported historical advances in aneurysm surgery fell into five themes: (1) optimising clip placement, (2) minimising brain retraction, (3) tissue handling, (4) visualisation and orientation, and (5) management of intraoperative rupture. The most frequently reported innovation by far was indocyanine green angiography (84% of respondents). The three most commonly cited future advances were hybrid surgical and endovascular techniques, advances in intraoperative imaging, and patient-specific simulation and planning. CONCLUSIONS: While some surgeons perceive that the rate of innovation in aneurysm clipping has been dwarfed in recent years by endovascular techniques, surgeons surveyed highlighted a broad range of future technologies that have the potential to continue to improve the safety of aneurysm surgery in the future.
| Type: | Article |
|---|---|
| Title: | Microsurgery for intracranial aneurysms: A qualitative survey on technical challenges and technological solutions |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.3389/fsurg.2022.957450 |
| Publisher version: | https://doi.org/10.3389/fsurg.2022.957450 |
| Language: | English |
| Additional information: | © 2022 Muirhead, Layard Horsfall, Khan, Koh, Grover, Toma, Castanho, Stoyanov, Marcus and Murphy. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
| Keywords: | Aneurysm clipping, subarachnoid haemorrhage, technology, survey, microsurgery |
| UCL classification: | UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10153393 |
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