Kim Yong Bae, Lee Jae Whan, Lee Kyu Chang, Choi Yoon Jung
Department of Neurosurgery, Cerebrovascular Center, National Health Insurance Corporation Ilsan Hospital, Koyang, Korea.
Acta Neurochir (Wien). 2009 Jun;151(6):613-8; discussion 618. doi: 10.1007/s00701-009-0318-1. Epub 2009 Apr 28.
A 57-year-old woman presented with a progressive deterioration of vision. She had previously undergone clipping for a ruptured small anterior communicating artery (Acom) aneurysm 7 years prior to admission and additional coiling for recurrence 2 years prior to admission. Angiography showed regrown out-pouching of the sac, which measured 27 x 18 mm. A decision was made to perform surgical treatment to alleviate the mass effect of the aneurysm. Unique techniques for revision of the scarred surgical corridor, removal of old clips, resection of the coiled mass, thrombectomy, and intra-aneurysmal endarterectomy were required to allow placement of the final clips. The patient recovered uneventfully, and her vision was satisfactorily restored.
一名57岁女性因视力进行性恶化前来就诊。她在入院前7年曾因破裂的小型前交通动脉（Acom）动脉瘤接受夹闭手术，入院前2年因复发接受了额外的栓塞治疗。血管造影显示瘤囊有重新长出的外凸部分，大小为27×18毫米。决定进行手术治疗以减轻动脉瘤的占位效应。需要采用独特的技术来修复瘢痕化的手术通道、移除旧夹子、切除栓塞团块、进行血栓切除术以及动脉瘤内动脉内膜切除术，以便放置最终的夹子。患者恢复顺利，视力得到了令人满意的恢复。
