Delimitation of the risk area of the vertebral artery during the paramedian suboccipital approach.

Villamil, Facundo; Caffaratti, Guido; Ruella, Mauro; Domecq, Lucila; Calandri, Ismael Luis; Darakdjian, Maximiliano; Nuñez, Maximiliano; Mormandi, Rubén; Cervio, Andrés Eduardo

dc.contributor.author	Villamil, Facundo
dc.contributor.author	Caffaratti, Guido
dc.contributor.author	Ruella, Mauro
dc.contributor.author	Domecq, Lucila
dc.contributor.author	Calandri, Ismael Luis
dc.contributor.author	Darakdjian, Maximiliano
dc.contributor.author	Nuñez, Maximiliano
dc.contributor.author	Mormandi, Rubén
dc.contributor.author	Cervio, Andrés Eduardo
dc.date.accessioned	2024-05-14T12:54:39Z
dc.date.available	2024-05-14T12:54:39Z
dc.date.issued	2024-03-29
dc.identifier.citation	Villamil F, Caffaratti G, Ruella M, Laplace LD, Calandri I, Darakdjian M, Nuñez M, Mormandi R, Cervio A. Delimitation of the risk area of the vertebral artery during the paramedian suboccipital approach. Clin Neurol Neurosurg. 2024 May;240:108269. doi: 10.1016/j.clineuro.2024.108269. Epub 2024 Mar 29.	es_ES
dc.identifier.uri	https://doi.org/10.1016/j.clineuro.2024.108269
dc.identifier.uri	https://repositorio.fleni.org.ar/xmlui/handle/123456789/1110
dc.description.sponsorship	Objective: The V3 segment of the vertebral artery (V3-VA) is at risk during diverse approaches to the craniovertebral junction. Our objective is to present a system of anatomic and topographic landmarks to identify the V3-VA during the paramedian suboccipital approach (PMSOA) with the help of minimal or basic tools. Material and methods: The first was a retrospective analysis of the angiotomography (CTA) of 50 patients over 18-years old, and 9 anatomical dissections. A series of lines were defined between the different bony landmarks. Within this lines the risk area of the vertebral artery (RAsV3-VA) and the risk point of the vertebral artery (RPsV3-VA) were defined. The second stage was a prospective study, where the previously defined measurements were carried out by using neuronavigation in 10 patients (20 sides) operated with the PMSO approach in order to confirm the presence of the V3 segment in the RAsV3-VA and RPsV3-VA. Results: In the first stage, the V3 segment was found in the middle third of the X line in 96,6% of the cases. The distance between the inion and the UCP (percentile 5) was 20 mm and to the LCP (percentile 95) was 40 mm. In the range between the UCP and the LCP, in the middle third of the inion-mastoid line (RAsV3-VA), we found 90% of the V3-VA. The measurements taken during the second stage revealed that the artery was in the middle third of the X line in 97% of the cases. 85% of the patients presented the total of the V3s-VA on the RAsV3-VA and in 85% there was a direct relationship with the V3 segment and the RPV3s-VA. Conclusion: We propose an easy-to-implement system to delimit the risk area of the V3-VA during the PMSOA. We believe that these landmarks provide a practical, reliable, costless and useful tool that could decrease the risk of lesion of the V3-VA during this approach without the need of using.	es_ES
dc.language.iso	eng	es_ES
dc.publisher	Elsevier	es_ES
dc.subject	Arteria Vertebral	es_ES
dc.subject	Vertebral Artery	es_ES
dc.subject	Neurocirugia	es_ES
dc.subject	Neurosurgery	es_ES
dc.title	Delimitation of the risk area of the vertebral artery during the paramedian suboccipital approach.	es_ES
dc.type	info:eu-repo/semantics/article	es_ES
dc.description.fil	Fil: Villamil, Facundo. Fleni. Departamento de Neurocirugía; Argentina.
dc.description.fil	Fil: Caffaratti, Guido. Fleni. Departamento de Neurocirugía; Argentina.
dc.description.fil	Fil: Ruella, Mauro. Fleni. Departamento de Neurocirugía; Argentina.
dc.description.fil	Fil: Domecq, Lucila. Fleni. Departamento de Neurocirugía; Argentina.
dc.description.fil	Fil: Calandri, Ismael Luis. Fleni. Departamento de Neurología; Argentina.
dc.description.fil	Fil: Darakdjian, Maximiliano. Fleni. Departamento de Diagnóstico por Imágenes; Argentina.
dc.description.fil	Fil: Nuñez, Maximiliano. University of Pittsburgh Medical Center; Estados Unidos.
dc.description.fil	Fil: Mormandi, Rubén. Fleni. Departamento de Neurocirugía; Argentina.
dc.description.fil	Fil: Cervio, Andrés Eduardo. Fleni. Departamento de Neurocirugía; Argentina.
dc.relation.ispartofVOLUME	240
dc.relation.ispartofPAGINATION	108269
dc.relation.ispartofCOUNTRY	Países Bajos
dc.relation.ispartofCITY	Ámsterdam
dc.relation.ispartofTITLE	Clinical neurology and neurosurgery
dc.relation.ispartofISSN	1872-6968
dc.type.snrd	info:ar-repo/semantics/artículo	es_ES