{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T15:51:35Z","timestamp":1762876295457},"reference-count":7,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\nBackground: <\/jats:title>\nIn recent years, young neurosurgeons have had few opportunities to gain experience with clipping surgeries. The first author was sometimes surprised that she could not predict the anatomical relationships between the aneurysm and vessels during actual surgery. This study investigated the differences between the expected and actual operative findings during clipping surgery for aneurysms of the middle cerebral artery.<\/jats:p>\n<\/jats:sec>\n\nMethods: <\/jats:title>\nMedical records for 15 patients who underwent rotational three-dimensional (3D) digital subtraction angiography (3D-DSA) before the clipping surgery were analyzed after the surgery. The anatomical relationships between the aneurysm and parent arteries were defined by the intraoperative findings just before clipping. The viewing direction to obtain this definitive perspective (virtual viewing direction) was measured. The angle between this viewing direction and the coordinate axis was denoted as the \u201cvirtual angle for clipping (VAC).\u201d<\/jats:p>\n<\/jats:sec>\n\nResults: <\/jats:title>\nThe VAC between the X-axis and viewing direction on the XY-plane (VAC-XY) ranged from \u201343\u00b0 to +73\u00b0 (mean, +27\u00b0), and the angle between the XY-plane and viewing direction (VAC-Z) ranged from +25\u00b0 to \u201334\u00b0 (mean, 5.5\u00b0). The difference between the VAC-XY and mean angle was significantly larger in cases with hidden branches behind the aneurysm. In these cases, the virtual viewing direction visualized the neck of the aneurysm. There is no correlation between M1 length and VAC-XY or VAC-Z discrepancy.<\/jats:p>\n<\/jats:sec>\n\nConclusion: <\/jats:title>\n3D-DSA or 3D computed tomography angiography images visualizing the neck of the aneurysm should be obtained in combination with images obtained from the standard oblique angle.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_934_2020","type":"journal-article","created":{"date-parts":[[2021,2,23]],"date-time":"2021-02-23T08:06:57Z","timestamp":1614067617000},"page":"70","update-policy":"http:\/\/dx.doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Preoperative simulation of a middle cerebral artery aneurysm clipping using a rotational three-dimensional digital subtraction angiography"],"prefix":"10.25259","volume":"12","author":[{"given":"Yuiko","family":"Kimura","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Jichi Medical University, Shimotsuke, Tochigi, Tokyo, Japan"},{"name":"Department of Neurosurgery, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshihiro","family":"Mashiko","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Jichi Medical University, Shimotsuke, Tochigi, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eiju","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Jichi Medical University, Shimotsuke, Tochigi, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kensuke","family":"Kawai","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Jichi Medical University, Shimotsuke, Tochigi, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2021,2,23]]},"reference":[{"key":"10.25259\/SNI_934_2020\/ref-1","first-page":"52","article-title":"Virtual reality cerebral aneurysm clipping simulation with real-time haptic feedback","volume":"11","author":"Alaraj","year":"2015","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_934_2020\/ref-2","doi-asserted-by":"crossref","first-page":"832","DOI":"10.1590\/0004-282X20140156","article-title":"Head positioning for anterior circulation aneurysms microsurgery","volume":"72","author":"Chaddad-Neto","year":"2014","journal-title":"Arq Neuropsiquiatr"},{"key":"10.25259\/SNI_934_2020\/ref-3","article-title":"Operative Neurosurgical Anatomy","author":"Fossett","year":"2002","edition":"4th ed"},{"key":"10.25259\/SNI_934_2020\/ref-4","first-page":"355","article-title":"Simulation of the surgical manipulation involved in clipping a basilar artery aneurysm: Concepts of virtual clipping.Technical note","volume":"93","author":"Koyama","year":"2000","journal-title":"J Neurol Surg"},{"key":"10.25259\/SNI_934_2020\/ref-5","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1016\/j.wneu.2013.10.032","article-title":"Development of three-dimensional hollow elastic model for cerebral aneurysm clipping simulation enabling rapid and low cost prototyping","volume":"83","author":"Mashiko","year":"2015","journal-title":"World Neurosurg"},{"key":"10.25259\/SNI_934_2020\/ref-6","doi-asserted-by":"crossref","first-page":"191","DOI":"10.4103\/0028-3886.96399","article-title":"Stereoscopic virtual realistic surgical simulation in intracranial aneurysms","volume":"60","author":"Nakabayashi","year":"2012","journal-title":"Neurol India"},{"key":"10.25259\/SNI_934_2020\/ref-7","article-title":"Schmidek and Sweet Operative Neurosurgical Techniques","author":"Quinones-Hinojosa","year":"2012","edition":"6th ed"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/preoperative-simulation-of-a-middle-cerebral-artery-aneurysm-clipping-using-a-rotational-three-dimensional-digital-subtraction-angiography\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/preoperative-simulation-of-a-middle-cerebral-artery-aneurysm-clipping-using-a-rotational-three-dimensional-digital-subtraction-angiography\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,23]],"date-time":"2021-02-23T08:07:02Z","timestamp":1614067622000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/preoperative-simulation-of-a-middle-cerebral-artery-aneurysm-clipping-using-a-rotational-three-dimensional-digital-subtraction-angiography\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,23]]},"references-count":7,"alternative-id":["10.25259\/SNI_934_2020"],"URL":"https:\/\/doi.org\/10.25259\/sni_934_2020","relation":{},"ISSN":["2152-7806"],"issn-type":[{"value":"2152-7806","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,23]]},"article-number":"70"}}