{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:50:17Z","timestamp":1786125017453,"version":"build-2736575974"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Operative Surg.","ONSURG"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:bold>BACKGROUND:<\/jats:bold>\n                    Most high-riding distal basilar trunk aneurysms can be surgically approached via the transsylvian route and its orbitozygomatic variant. However, on rare occasions, the basilar bifurcation may be unusually high and an approach above the carotid terminus may be required.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>OBJECTIVE:<\/jats:bold>\n                    In this cadaveric study, we sought to determine the feasibility and exposure limits of the interlenticulostriate approach (ILSA).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>METHODS:<\/jats:bold>\n                    A standard transsylvian approach was performed in 10 cerebral hemispheres of 5 formalin-fixed, silicone-injected cadaver heads. The interpeduncular cistern was exposed via the opticocarotid window, carotid-oculomotor window, and supracarotid ILSA window. The latter was measured and an aneurysm clip or ventriculostomy stylet was placed as high as possible through each corridor. Using noncontrast 3-D rotational angiography, clip\/stylet positions were measured relative to the dorsum sellae.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>RESULTS:<\/jats:bold>\n                    ILSA provided a 9.4 \u00d7 4.6 mm mean surgical corridor, just enough room for a standard clip applier. This space was limited by the carotid bifurcation inferiorly, the lenticulostriate arteries medially and laterally, and the optic tract superiorly. There was no difference between opticocarotid and carotid-oculomotor windows, in terms of clip position (+8.9 vs +8.6 mm, respectively;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = .78). In contrast, ILSA provided significantly improved superior exposure, compared with either approaches (mean stylet position: +14.3 mm;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = .005). The exposure benefit afforded by ILSA was consistent across all 10 hemispheres, ranging from +2.5 to +8 mm.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>CONCLUSION:<\/jats:bold>\n                    For high-riding distal basilar trunk aneurysms that cannot be reached via the frontotemporal orbitozygomatic approach, ILSA can provide a viable route of access. Vascular neurosurgeons should be familiarized with this approach.\n                  <\/jats:p>","DOI":"10.1093\/ons\/opw029","type":"journal-article","created":{"date-parts":[[2017,2,3]],"date-time":"2017-02-03T18:10:25Z","timestamp":1486145425000},"page":"338-344","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["The Interlenticulostriate Approach to Very High-Riding Distal Basilar Trunk Aneurysms"],"prefix":"10.1227","volume":"13","author":[{"given":"Ralph","family":"Rahme","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Cincinnati (UC) College of Medicine, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Almaz","family":"Kurbanov","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Cincinnati (UC) College of Medicine, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey T.","family":"Keller","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Cincinnati (UC) College of Medicine, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd A.","family":"Abruzzo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Cincinnati (UC) College of Medicine, Cincinnati, Ohio"},{"name":"Cerebrovascular Cen-ter, UC Neuroscience Institute, Cincinnati, Ohio"},{"name":"Mayfield Clinic, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lincoln","family":"Jimenez","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Cincinnati (UC) College of Medicine, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"Ringer","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Cincinnati (UC) College of Medicine, Cincinnati, Ohio"},{"name":"Cerebrovascular Cen-ter, UC Neuroscience Institute, Cincinnati, Ohio"},{"name":"Mayfield Clinic, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ondrej","family":"Choutka","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Cincinnati (UC) College of Medicine, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Zuccarello","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Cincinnati (UC) College of Medicine, Cincinnati, Ohio"},{"name":"Cerebrovascular Cen-ter, UC Neuroscience Institute, Cincinnati, Ohio"},{"name":"Mayfield Clinic, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2017,6]]},"reference":[{"key":"bib1-20240909","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1227\/01.NEU.0000255433.47044.8F","article-title":"Endovascular coil embolization of ruptured and unruptured posterior circulation aneurysms: review of a 10-year experience","volume":"60","author":"Pandey","year":"2007","journal-title":"Neurosurgery"},{"key":"bib2-20240909","first-page":"1236","article-title":"The current role of microsurgery for posterior circulation aneurysms: a selective approach in the endovascular era","volume":"62","author":"Sanai","year":"2008","journal-title":"Neurosurgery"},{"key":"bib3-20240909","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1161\/01.STR.31.1.100","article-title":"Endovascular treatment of ruptured posterior circulation cerebral aneurysms. 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