RESUMEN
INTRODUCTION: The use of minimally invasive procedures in neurosurgery permits a significant reduction in peri-operative morbidity and duration of hospital stay. The fronto-latero-basal (FLB) approach gives good exposure of the structures of the anterior and middle fossas with access to most aneurysms of the anterior circulation, thus avoiding extensive craniotomies and the use of brain retractors. OBJECTIVE: We present an analysis of 27 patients operated on to clip 29 aneurysms of the anterior circulation using the FLB approach. PATIENTS AND METHODS: The study included 27 patients, 18 women and 9 men with an average age of 47.53 years. On clinical staging, using the Hunt and Hess scale, 12 patients were between 0 and 1, 8 at stage II, 6 at stage III and 1 at stage IV. RESULTS: The aneurysms were mainly on the internal carotid artery (16), middle cerebral artery (5), anterior communicating artery (5) and bifurcation of the carotid and middle cerebral arteries (3). The surgical operation lasted an average of 166.15 minutes; it was possible to clip the artery in 28 cases (96.5%). Two patients died (of renal failure and of disseminated intravascular coagulation). Most patients were discharged with a score of 5 points on the Glasgow prognosis scale 7.6 days after operation. CONCLUSIONS: Use of minimally invasive procedures such as FLB gives optimal functional and aesthetic results, with the advantage of being possible using the basic instruments available in any neurosurgical department, without depending on advanced technology.
