Britz Gavin W
Houston Methodist Hospital, Houston, Texas.
Methodist Debakey Cardiovasc J. 2014 Oct-Dec;10(4):220-3. doi: 10.14797/mdcj-10-4-220.
Cerebral aneurysms are an important health issue in the United States, and the mortality rate following aneurysm rupture, or SAH, remains high. The treatment of these aneurysms uses endovascular options which include coil placement, stent assistant coiling and, recently, flow diversion. However, microsurgical clipping remains an option in those aneurysms not suited for endovascular therapy. These are often the more complicated aneurysms such as in large, giant aneurysms or deep-seated aneurysms. Circumferential visualization of the aneurysm, parent vessels, branches, perforators, and other neurovascular structures is important to prevent residual aneurysms or strokes from vessel or perforator occlusion. Decompression of the aneurysm sac is often required and we believe that adenosine-induced transient asystole should be an important option for clipping of complex cerebral aneurysms.
脑动脉瘤在美国是一个重要的健康问题，动脉瘤破裂（即蛛网膜下腔出血，SAH）后的死亡率仍然很高。这些动脉瘤的治疗采用血管内治疗方法，包括弹簧圈置入、支架辅助弹簧圈栓塞，以及最近出现的血流导向治疗。然而，对于那些不适合血管内治疗的动脉瘤，显微手术夹闭仍是一种选择。这些通常是更复杂的动脉瘤，如大型、巨大型动脉瘤或深部动脉瘤。对动脉瘤、载瘤血管、分支、穿支血管和其他神经血管结构进行全方位观察，对于预防因血管或穿支血管闭塞导致的残留动脉瘤或中风至关重要。通常需要对动脉瘤囊进行减压，我们认为腺苷诱导的短暂心脏停搏应该是夹闭复杂脑动脉瘤的一个重要选择。
