{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:51:44Z","timestamp":1786125104090,"version":"build-2736575974"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Operative Surg.","ONSURG"],"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:bold>BACKGROUND:<\/jats:bold>\n                    Although recent technological advances have led to successful endovascular treatment, middle cerebral artery (MCA) aneurysms are still prone to surgery. Because minimally invasive options are limited and possess several functional and cosmetic drawbacks, a transpalpebral approach is proposed as a new alternative.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>OBJECTIVES:<\/jats:bold>\n                    To describe and assess surgical results of the minimally invasive transpalpebral approach in patients with MCA aneurysms.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>METHODS:<\/jats:bold>\n                    The data of 25 patients with unruptured MCA aneurysms from 2013 to 2016 were included in a cohort prospective database. We describe modifications of the approach and technique for MCA aneurysm clipping, in a step-by-step manner. The outcome was based on complications, procedural morbidity and mortality, and clinical and angiographic outcomes.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>RESULTS:<\/jats:bold>\n                    All procedures were successfully performed in a standardized way, and no major complications related to the new approach were observed. Twenty-two patients were discharged the day after surgery (88%). The majority of aneurysms were 5 to 6 mm in diameter (mean, 7 mm; range 4-21 mm). All patients underwent postoperative angiographic control, which showed no significant residual neck. A 3-mo follow-up was sufficient to show no visible scars with excellent cosmetic results. The mean duration of follow-up was 16 mo.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>CONCLUSION:<\/jats:bold>\n                    The transpalpebral approach comes as a minimally invasive, safe, definitive, and cosmetically adequate solution for MCA aneurysms at the present time.\n                  <\/jats:p>","DOI":"10.1093\/ons\/opx021","type":"journal-article","created":{"date-parts":[[2017,5,13]],"date-time":"2017-05-13T02:31:14Z","timestamp":1494642674000},"page":"453-464","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":16,"title":["Minimally Invasive Transpalpebral \u2018\u2018Eyelid\u2019\u2019 Approach to Unruptured Middle Cerebral Artery Aneurysms"],"prefix":"10.1227","volume":"13","author":[{"given":"Mauricio","family":"Mandel","sequence":"first","affiliation":[{"name":"Division of Neurosurgery, Hospital das Cl\u00ednicas of University of S\u00e3o Paulo Medical School, S\u00e3o Paulo, Brazil"},{"name":"Hospital Israelita Albert Einstein, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"Tutihashi","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Hospital das Cl\u00ednicas of University of S\u00e3o Paulo Medical School, S\u00e3o Paulo, Brazil"},{"name":"Hospital Israelita Albert Einstein, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzana Abramovicz","family":"Mandel","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Hospital das Cl\u00ednicas of University of S\u00e3o Paulo Medical School, S\u00e3o Paulo, Brazil"},{"name":"Hospital Israelita Albert Einstein, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manoel Jacobsen","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Hospital das Cl\u00ednicas of University of S\u00e3o Paulo Medical School, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eberval Gadelha","family":"Figueiredo","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Hospital das Cl\u00ednicas of University of S\u00e3o Paulo Medical School, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2017,8]]},"reference":[{"issue":"2","key":"bib1-20240909","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1016\/j.wneu.2012.12.011","article-title":"Middle cerebral artery aneurysms: a single-center series comparing endovascular and surgical treatment","volume":"81","author":"Diaz","year":"2014","journal-title":"World Neurosurg"},{"issue":"6","key":"bib2-20240909","doi-asserted-by":"crossref","first-page":"1247","DOI":"10.1007\/s00701-011-1008-3","article-title":"Treatment results for complex middle cerebral artery aneurysms. 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