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动脉粥样硬化母动脉中小侧壁动脉瘤血管造影与手术结果的差异。

Discrepancy between Angiography and Operative Findings of Small Side Wall Aneurysms in Atherosclerotic Parent Arteries.

作者信息

Sim Sook Young

机构信息

Department of Neurosurgery, Inje University Seoul Paik Hospital, Seoul, Korea.

出版信息

J Cerebrovasc Endovasc Neurosurg. 2017 Mar;19(1):44-47. doi: 10.7461/jcen.2017.19.1.44. Epub 2017 Mar 31.

DOI:10.7461/jcen.2017.19.1.44
PMID:28503487
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5426195/
Abstract

Preoperative evaluation of precise aneurysmal geometry is important for the treatment of intracranial aneurysms. We present two cases of unclippable side wall aneurysms due to their extremely low dome height, which appeared as saccular in the preoperative image because of a comparatively narrow atherosclerotic parent arterial lumen. In both cases, a calcified vessel wall was noted preoperatively. Lack of a definitive neck and abrupt discrepancy between the fragile aneurysmal wall and the atherosclerotic parent arterial wall was confirmed intraoperatively in both cases. This study describes an illustrative mechanism for the finding with emphasis on the importance of its preoperative diagnosis. Intracranial atherosclerosis associated with small side walled aneurysms may lead to overestimation of aneurysm height on preoperative imaging of the intravascular compartment.

摘要

精确评估动脉瘤的术前几何形态对于颅内动脉瘤的治疗至关重要。我们报告两例因瘤顶高度极低而无法夹闭的侧壁动脉瘤病例，由于动脉粥样硬化的载瘤动脉管腔相对狭窄，在术前影像中呈囊状。两例术前均发现钙化的血管壁。术中证实两例均缺乏明确的瘤颈，且脆弱的动脉瘤壁与动脉粥样硬化的载瘤动脉壁之间存在突然的差异。本研究描述了这一发现的说明性机制，并强调其术前诊断的重要性。与小侧壁动脉瘤相关的颅内动脉粥样硬化可能导致术前血管内腔成像时对动脉瘤高度的高估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d05/5426195/9d53a633e49d/jcen-19-44-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d05/5426195/9d15a108910b/jcen-19-44-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d05/5426195/4f99449dd4e3/jcen-19-44-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d05/5426195/9d53a633e49d/jcen-19-44-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d05/5426195/9d15a108910b/jcen-19-44-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d05/5426195/4f99449dd4e3/jcen-19-44-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d05/5426195/9d53a633e49d/jcen-19-44-g003.jpg

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