Department of Neurological Surgery, University of Wisconsin, Madison, Wisconsin 53792, USA.
Neurosurgery. 2012 Jun;70(2 Suppl Operative):339-42. doi: 10.1227/NEU.0b013e3182330ef7.
Fusiform intracranial aneurysms (FIAs) are challenging to treat by surgical and endovascular means because of their complex morphology and configurations. Various surgical techniques, including clip reconstruction, wrapping with or without clip enforcement, and trapping with or without bypass, have been described extensively. The objective of this study is to describe the application of a new fenestrated clip (Yaşargil T-bar clip) for the treatment of FIAs.
An FIA on the M1 segment of the middle cerebral artery was diagnosed incidentally in a 23-year-old man. The aneurysm was visualized after wide dissection of the sylvian fissure. The M1 segment of the middle cerebral artery, its branches, and its lenticulostriate arteries were identified and dissected. A single fenestrated T-bar clip was applied to reconstruct this long FIA after one of the lenticulostriate arteries was dissected free of the aneurysm. Postoperative angiography confirmed reconstruction of the M1 segment and obliteration of the aneurysm.
Clip reconstruction of an FIA with a fenestrated Yaşargil T-bar clip is a new application option that effectively reconstructs the parent artery. Application of this type of a clip might be advantageous over conventional fenestrated or nonfenestrated clip applications, especially in tight surgical fields, because a single clip might be sufficient to reconstruct the long segment of the artery.
梭形颅内动脉瘤（FIAs）因其复杂的形态和构型，用手术和血管内方法治疗具有挑战性。已经广泛描述了各种手术技术，包括夹重建、夹夹闭伴或不伴夹加固、夹闭伴或不伴旁路。本研究的目的是描述一种新型开窗夹（Yaşargil T 形夹）在治疗 FIAs 中的应用。
一名 23 岁男性偶然诊断出大脑中动脉 M1 段的 FIA。在广泛切开大脑外侧裂后可见到该动脉瘤。识别并解剖大脑中动脉 M1 段、其分支及其纹状体动脉。在一条纹状体动脉游离动脉瘤后，应用单个开窗 T 形夹重建此长段 FIA。术后血管造影证实重建了 M1 段并闭塞了动脉瘤。
使用开窗 Yaşargil T 形夹夹闭 FIA 是一种重建母动脉的新应用选择。与传统的开窗或非开窗夹应用相比，这种夹的应用可能具有优势，特别是在狭窄的手术野中，因为单个夹可能足以重建长段动脉。
