Kars Hamit Zafer, Gurelik Mustafa
Cumhuriyet University, Faculty of Medicine, Department of Neurosurgery, Sivas, Turkey.
Turk Neurosurg. 2011 Jan;21(1):53-8.
Surgical outcome for giant intracranial aneurysms (GIA) is suboptimal. Reasons for higher complication rates in large and GIA surgery are the occlusion of perforators or parent arteries during aneurysm clipping, or prolonged temporary occlusion of main arteries. In this article, results of clipping of large and GIAs of anterior circulation are presented.
Ten patients with large or GIAs in the anterior circulation were treated by clipping (10/19, 52%). The most common location was the middle cerebral artery (MCA, 5/10), followed by the anterior cerebral artery (ACA, 3/10), and internal carotid artery (ICA, 2/10). Five aneurysms were large (17-20 mm), five were giant (27-53 mm).
Uneventful aneurysm clipping was performed in eight, and cure was obtained in nine patients. Mortality and morbidity figures were 10% (1/10), and 0% (0/10), respectively. Mean follow up time is 2.8 years (range 1-10 years).
Clipping is still the most common surgical method of dealing with these lesions. Clipping of all large and giant aneurysms of anterior circulation was achieved in our patients with 10% mortality and 0% morbidity rates. These rates are similar to figures reported in previous series. Clipping of large and giant aneurysms is still the best definitive treatment, and is applicable in majority of the patients.
巨大颅内动脉瘤（GIA）的手术效果欠佳。大型和GIA手术并发症发生率较高的原因是在动脉瘤夹闭过程中穿支动脉或供血动脉被阻断，或主要动脉的临时阻断时间延长。本文介绍了前循环大型和GIA夹闭的结果。
10例前循环大型或GIA患者接受了夹闭治疗（10/19，52%）。最常见的部位是大脑中动脉（MCA，5/10），其次是大脑前动脉（ACA，3/10）和颈内动脉（ICA，2/10）。5个动脉瘤为大型（17 - 20mm），5个为巨大型（27 - 53mm）。
8例患者顺利完成动脉瘤夹闭，9例患者治愈。死亡率和发病率分别为10%（1/10）和0%（0/10）。平均随访时间为2.8年（范围1 - 10年）。
夹闭仍然是处理这些病变最常用的手术方法。我们的患者中前循环所有大型和巨大动脉瘤夹闭的死亡率为10%，发病率为0%。这些比率与先前系列报道的数据相似。大型和巨大动脉瘤夹闭仍然是最佳的确定性治疗方法，并且适用于大多数患者。
