Tailoring the surgical corridor to the basilar apex in the pretemporal transcavernous approach: morphometric analyses of different neurovascular mobilization maneuvers.

Excerpt

We commend the authors for their efforts to formalize an approach to basilar apex aneurysms. Key to the approach of any aneurysm is the establishment of proximal control as well as the ability to dissect and visualize the neck of the aneurysm to ensure appropriate clip placement, which can be particularly challenging in basilar aneurysms given its anatomic location and deep perforators. Given the variable anatomy of the basilar artery, numerous approaches and schema have been developed and described in the literature [1]. Historically, the pterional and subtemporal approaches were described to access the basilar apex; however, numerous other techniques have been developed to facilitate access to the basilar artery and expand the surgical corridor, including the orbitozygomatic craniotomy, various transpetrosal approaches, and the endoscopic transclival approach [1‐6]. …