Lu Chunli, Li Huanting, Li Shifang, Li Zhaojian, Feng Yugong
Department of Neurosurgery, China International Neuroscience Institute (CHINA-INI), Xuanwu Hospital, Capital Medical University, Beijing, China.
Department of Neurosurgery, the Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China.
Br J Neurosurg. 2023 Apr;37(2):170-176. doi: 10.1080/02688697.2021.2010649. Epub 2021 Dec 6.
To present a consecutive 20-year series of blood blister-like aneurysms (BBAs) to show that clip-on-wrapping with a Y-shaped autologous dura mater enables treatment of BBAs with a low complication rate and a satisfactory curative result.
A retrospective review was performed from patients with BBAs of the internal carotid artery (ICA) at the Affiliated Hospital of Qingdao University from 1999 to 2019. Diagnosis and treatment options were analyzed. Outcome was assessed using the modified Rankin scale (mRS).
A total of 30 patients with BBAs of the ICA were included. Among these patients, 20 patients underwent microsurgical treatment (15 patients were treated by clip-on-wrapping with a Y-shaped autologous dura mater), the other 10 patients underwent endovascular treatment. All patients presented with subarachnoid hemorrhage (SAH). Four angiograms were initially negative. For all patients, intraoperative rupture occurred in five cases, but no postoperative aneurysm rupture occurred in this series. Three cases with clinical or radiologic cerebral infarctions were observed. The outcome was favorable in 26 patients.
Clip-reinforced wrapping technique using a Y-shaped autologous dura mater may be an effective method for treating BBAs.
呈现连续20年的血泡样动脉瘤（BBAs）病例系列，以表明采用Y形自体硬脑膜夹闭包裹术能够以低并发症发生率和满意的治疗效果治疗BBAs。
对1999年至2019年青岛大学附属医院颈内动脉（ICA）BBAs患者进行回顾性研究。分析诊断和治疗选择。采用改良Rankin量表（mRS）评估结果。
共纳入30例ICA的BBAs患者。其中，20例患者接受了显微手术治疗（15例采用Y形自体硬脑膜夹闭包裹术治疗），另外10例患者接受了血管内治疗。所有患者均表现为蛛网膜下腔出血（SAH）。4例血管造影最初为阴性。所有患者中，术中破裂5例，但本系列中无术后动脉瘤破裂发生。观察到3例临床或影像学脑梗死病例。26例患者预后良好。
采用Y形自体硬脑膜的夹闭强化包裹技术可能是治疗BBAs的有效方法。
