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颅内血管病变神经血管内手术的经桡动脉入路

Transradial approach for neuroendovascular surgery of intracranial vascular lesions.

作者信息

Eskioglu Eric, Burry Matthew V, Mericle Robert A

机构信息

Department of Neurological Surgery, University of Florida, Gainesville, Florida 32610-0265, USA.

出版信息

J Neurosurg. 2004 Nov;101(5):767-9. doi: 10.3171/jns.2004.101.5.0767.

Abstract

OBJECT

The authors present their experience in performing a transradial approach for neuroendovascular surgery of intracranial vascular lesions when a transfemoral approach was unfavorable.

METHODS

Eight patients ranging in age from 52 to 88 years underwent a total of nine neuroendovascular procedures for intracranial vascular lesions. A transradial approach was used in all patients. The patients had previously undergone a transfemoral approach for the endovascular intervention, but that procedure was unsuccessful. Five patients had intracranial basilar artery (BA) aneurysms, one patient had symptomatic BA stenosis, one patient had a dural arteriovenous fistula in the posterior fossa, and one patient had a high-flow arteriovenous malformation in the frontal lobe. In each case, a transradial approach achieved a stable platform that allowed intracranial microcatheterization for neuroendovascular intervention. None of the patients experienced complications attributed to the transradial artery approach.

CONCLUSIONS

During neuroendovascular surgery for the treatment of intracranial lesions, the transradial approach is a viable alternative if the transfemoral approach is unfavorable. This series represents the first known description of neuroendovascular surgery for intracranial lesions via a transradial approach.

摘要

目的

作者介绍了在经股动脉入路不利于操作时,采用经桡动脉入路进行颅内血管病变神经血管内手术的经验。

方法

8例年龄在52至88岁之间的患者共接受了9次针对颅内血管病变的神经血管内手术。所有患者均采用经桡动脉入路。这些患者此前曾接受过经股动脉入路的血管内介入治疗,但该手术未成功。5例患者患有颅内基底动脉(BA)动脉瘤,1例患者有症状性BA狭窄,1例患者在后颅窝有硬脑膜动静脉瘘,1例患者在额叶有高流量动静脉畸形。在每种情况下,经桡动脉入路都提供了一个稳定的平台,允许进行颅内微导管插入以进行神经血管内介入治疗。没有患者出现与经桡动脉入路相关的并发症。

结论

在神经血管内手术治疗颅内病变时,如果经股动脉入路不利,经桡动脉入路是一种可行的替代方法。本系列代表了首次已知的通过经桡动脉入路进行颅内病变神经血管内手术的描述。

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