Use of Hunterian Ligation in the Treatment of Subarachnoid Giant Aneurysms

摘要

The preferred treatment of aneurysms is surgical clipping of the aneurysmal neck to prevent further rupture or enlargement. However, not all aneurysms can be directly clipped (or coiled) and, in these patients, proximal artery (Hunterian) ligation is a well-established alternative. Careful preoperative patient evaluation and a thoughtful approach to timing and site of direct occlusion yield the best results in terms of patient outcome. This article reviews the rationale, preoperative evaluation, and surgical techniques for Hunterian ligation of giant aneurysms. The outcomes from published series, predictors of outcome, and potential complications are also reviewed.