手术治疗巨大颈内动脉床突旁和椎基底动脉瘤时的临时球囊阻断。
Temporary balloon occlusion during the surgical treatment of giant paraclinoid and vertebrobasilar aneurysms.
机构信息
Department of Neurosurgery, Udine University Hospital, 33100 Udine, Italy.
出版信息
Acta Neurochir (Wien). 2010 Mar;152(3):435-42. doi: 10.1007/s00701-009-0566-0. Epub 2009 Nov 22.
PURPOSE
We propose the combined neurosurgical-endovascular treatment with the balloon occlusion of parent artery during surgery of giant paraclinoid and vertebrobasilar aneurysms, which are unsuitable for a pure endovascular or surgical approach.
METHODS
Between January 2003 and December 2007, we treated surgically 15 giant aneurysms (11 paraclinoid and four vertebrobasilar) with the combined approach of surgery and endovascular intraoperative technique.
FINDINGS
Complete aneurysm occlusion was achieved in all 15 aneurysms, as confirmed by intraoperative angiographic control. In one paraclinoid aneurysm, a small recurrence became evident 1 year after surgery and needed coil embolisation.
CONCLUSIONS
The temporary balloon occlusion technique is useful and improves the safety of the unavoidable exposure of the parent artery in the surgical treatment of giant paraclinoid and vertebrobasilar aneurysms.
目的
我们提出在手术治疗巨大颈内动脉旁和椎基底动脉动脉瘤时采用联合神经外科-血管内治疗方法，即在术中对载瘤动脉进行球囊阻塞，适用于不适合单纯血管内或手术治疗的情况。
方法
2003 年 1 月至 2007 年 12 月，我们采用手术联合术中血管内技术治疗了 15 例巨大动脉瘤（11 例颈内动脉旁，4 例椎基底动脉）。
结果
通过术中血管造影控制证实，15 例动脉瘤均达到完全闭塞。在 1 例颈内动脉旁动脉瘤中，术后 1 年出现小的复发，需要进行线圈栓塞。
结论
临时球囊阻塞技术在手术治疗巨大颈内动脉旁和椎基底动脉动脉瘤时对不可避免暴露载瘤动脉非常有用，可以提高安全性。
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