Filatov Iu M, Eliava Sh Sh, Kheĭreddin A S, Kornienko V N, Lubnin A Iu, Sazonova O B, Tropinskaia O F
Zh Vopr Neirokhir Im N N Burdenko. 2000 Oct-Dec(4):3-9; discussion 9.
The efficiency of a procedure of intravascular blood aspiration (IVBA) in patients with large and giant parawedge aneurysms of the internal carotid. The study was based on the analysis of clinical data and outcomes of surgical treatment in 20 patients with the aneurysms. The paper presents different procedures for IVBA, a complex of methods for preoperative examination of patients and intraoperative prediction of possible ischemic complications and defines indications for the IVBA procedure. Complete and partial aneurysm exclusion was achieved in 15 (75%) and 2 (10%) patients; the neck and walls of aneurysm were strengthened with surgical gauze in 2 (10%) patients. Incompetent clipping was observed in one case. There was recovery in 17 (85%), improvement in 2 (10%), 1 (5%) patients. No deaths occurred. The IVBA procedure for aneurysm is indicated for large and giant thin-walled non-thrombotic aneurysms of the parawedge carotid segment. It permit effective proximal monitoring of carotid blood flow and creates favourable conditions for preparing and excluding aneurysm, and, if necessary, forming a carotid lumen. Intraoperative monitoring of brain function is highly important and obligatory for early prediction and prevention of ischemic complications. Under intraoperative monitoring of brain function, fractional IVBA makes it effective even if collateral circulation is inadequate.
血管内血液抽吸术（IVBA）治疗颈内动脉大型和巨大型楔旁动脉瘤患者的疗效。该研究基于对20例患有此类动脉瘤患者的临床资料及手术治疗结果的分析。本文介绍了IVBA的不同操作方法、患者术前检查及术中预测可能缺血性并发症的综合方法，并明确了IVBA手术的适应症。15例（75%）患者实现了动脉瘤的完全和部分排除，2例（10%）患者用手术纱布加固了动脉瘤颈部和瘤壁。1例观察到夹闭不全。17例（85%）患者恢复，2例（10%）改善，1例（5%）。无死亡病例。动脉瘤的IVBA手术适用于楔旁颈动脉段大型和巨大型薄壁非血栓性动脉瘤。它允许对颈动脉血流进行有效的近端监测，并为准备和排除动脉瘤以及必要时形成颈动脉腔创造有利条件。术中脑功能监测对于早期预测和预防缺血性并发症非常重要且必不可少。在术中脑功能监测下，即使侧支循环不足，分次IVBA也能使其有效。
