Aymard A, Merland J J, Gobin P Y
Service de neuro-radiologie et d'angiographie thérapeutique, hôpital Lariboisière, Paris.
Agressologie. 1990 May;31(5):265-7.
Endovascular treatment of intracranial aneurysms is gaining an important development thanks to the further technical advances in catheters and occlusion materials (detachable and non detachable balloons). This treatment, performed under slight neuroleptanalgesia, allows access to the aneurysmal sac for selective occlusion with preservation of the parent vessel. In cases of fusiform or wide neck aneurysms, and if selective endosaccular occlusion is impossible or hazardous, the parent vessel occlusion can be performed with a test occlusion. Tolerance test occlusion of the parent vessel includes clinical monitoring, angiographic demonstration of good collateral supply and functional measures with local cerebral blood flux studies and transcranial doppler. This therapeutic approach is relatively simple in regard of neurosurgical treatment and allows improvement of the management of surgical high risk lesions.
由于导管和闭塞材料（可脱性和不可脱性球囊）技术的进一步发展，颅内动脉瘤的血管内治疗正取得重要进展。这种治疗在轻度神经安定镇痛下进行，能够进入动脉瘤囊进行选择性闭塞，同时保留载瘤血管。对于梭形或宽颈动脉瘤，如果选择性囊内闭塞不可能或有风险，则可通过试验性闭塞进行载瘤血管闭塞。载瘤血管的耐受性试验性闭塞包括临床监测、侧支循环良好的血管造影显示以及局部脑血流量研究和经颅多普勒的功能检测。与神经外科治疗相比，这种治疗方法相对简单，并且能够改善手术高危病变的处理。
