Balik Vladimir, Yamada Yasuhiro, Talari Sandeep, Yamashiro Kei, Wu Rile, Suyama Daisuke, Kawase Tsukasa, Takagi Kiyoshi, Takizawa Katsumi, Kato Yoko
Department of Neurosurgery, Faculty of Medicine and Dentistry, Palacky University, University Hospital Olomouc, Olomouc, Czech Republic -
Department of Neurosurgery, Fujita Health University, Banbuntane Hotokukai Hospital, Nagoya, Japan.
J Neurosurg Sci. 2017 Dec;61(6):640-651. doi: 10.23736/S0390-5616.16.03609-2. Epub 2016 Apr 28.
A lack of published surgical experience and higher symptomatic recurrence than previously recognized prompted the authors to present their experience with the surgical treatment of unruptured intracranial dissecting aneurysms (UIDAs). Hospital records, neuroimaging studies, operative reports, and follow-up records were retrospectively reviewed. All patients underwent surgical exploration of the lesion with proximal clipping of the parent artery through a far-lateral suboccipital craniotomy with or without partial condylar resection. The surgical treatment of vertebral artery-posterior inferior cerebellar artery UIDAs has acceptable risk regarding perioperative mortality and morbidity. The incidence of aneurysmal recurrence or the need for retreatment seems to be less than that associated with anticoagulation/antiplatelet therapy or endovascular treatment.
由于缺乏已发表的手术经验以及症状复发率高于先前认识到的情况，作者们展示了他们对未破裂颅内夹层动脉瘤（UIDAs）的手术治疗经验。对医院记录、神经影像学研究、手术报告和随访记录进行了回顾性审查。所有患者均通过远外侧枕下开颅术，在有或没有部分髁突切除的情况下，对病变进行手术探查并近端夹闭供血动脉。椎动脉-小脑后下动脉UIDAs的手术治疗在围手术期死亡率和发病率方面具有可接受的风险。动脉瘤复发或再次治疗的发生率似乎低于抗凝/抗血小板治疗或血管内治疗相关的发生率。
