Yanaka K, Matsumaru Y, Okazaki M, Noguchi S, Asakawa H, Anno I, Nose T
Department of Neurosurgery, Institute of Clinical Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Acta Neurochir (Wien). 2003 May;145(5):377-82; discussion 382-383. doi: 10.1007/s00701-003-0017-2.
The role of intraoperative angiography in the surgical treatment of cerebrovascular malformations remains controversial. The authors report on their experiences with intraoperative angiography in a series of 20 cases with cerebrovascular malformation to determine whether the use of intraoperative angiography has a favorable impact on the surgical treatment of cerebrovascular malformations.
Intraoperative angiography was performed in the surgical resection of arteriovenous malformation in 18 patients and in the surgical obliteration of arteriovenous fistula in 2 patients. The incidence of unexpected findings, such as residual nidus, demonstrated by intraoperative angiography was determined.
High-quality subtraction images were obtained by intraoperative angiography in every case and the findings prompted an additional procedure in 1 case that displayed an unexpected residual nidus (5.6%). There were no complications from the intraoperative angiography procedure.
Intraoperative assessment of technical results prior to wound closure offers the neurosurgeon the opportunity to resect or obliterate a vascular malformation completely, obviating a second operation.
术中血管造影在脑血管畸形外科治疗中的作用仍存在争议。作者报告了他们在一系列20例脑血管畸形患者中进行术中血管造影的经验，以确定术中血管造影的使用是否对脑血管畸形的外科治疗有积极影响。
对18例患者的动静脉畸形进行手术切除时进行术中血管造影，对2例患者的动静脉瘘进行手术闭塞时进行术中血管造影。确定术中血管造影显示的意外发现（如残留病灶）的发生率。
每例均通过术中血管造影获得高质量的减影图像，结果提示1例出现意外残留病灶（5.6%）的患者需要额外进行手术。术中血管造影操作无并发症发生。
在关闭伤口前对技术结果进行术中评估，为神经外科医生提供了完全切除或闭塞血管畸形的机会，从而避免二次手术。
