内镜经蝶窦经斜坡手术前行基底丛静脉栓塞术
Transvenous Embolization of the Basilar Plexus Before Endoscopic Transsphenoidal Transclival Surgery.
作者信息
Mizutani Katsuhiro, Akiyama Takenori, Toda Masahiro, Kanazawa Tokunori, Kamamoto Dai, Yoshida Kazunari
机构信息
Department of Neurosurgery, Keio University School of Medicine, Shinjukuku, Tokyo, Japan.
Department of Neurosurgery, Keio University School of Medicine, Shinjukuku, Tokyo, Japan.
出版信息
World Neurosurg. 2017 Jan;97:756.e13-756.e18. doi: 10.1016/j.wneu.2016.10.022. Epub 2016 Oct 15.
BACKGROUND
The endoscopic transclival approach is a method for reaching the anterior side of the brainstem. In making this approach, bleeding from the basilar plexus is often observed when cutting the dura overlying the clivus. Controlling such bleeding is essential.
CASE DESCRIPTION
We performed a transvenous embolization of the basilar plexus before making the transclival approach. After embolization, bleeding from the basilar plexus during the operation decreased considerably.
CONCLUSIONS
To our knowledge, this is the first report of transvenous embolization of the basilar plexus. If the basilar plexus is well developed on preoperative computed tomographic venography or digital subtraction angiography, this procedure is useful for controlling bleeding during endoscopic transclival surgery.
背景
经斜坡入路是一种到达脑干前侧的方法。在进行该入路时，切开斜坡上方硬脑膜时常常会出现基底静脉丛出血。控制此类出血至关重要。
病例描述
我们在经斜坡入路前对基底静脉丛进行了经静脉栓塞。栓塞后，术中基底静脉丛的出血明显减少。
结论
据我们所知，这是基底静脉丛经静脉栓塞的首例报告。如果术前计算机断层静脉造影或数字减影血管造影显示基底静脉丛发育良好，该操作有助于控制经鼻内镜斜坡手术中的出血。
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