Gallardo Federico Carlos, Bottan Juan Santiago, Martin Clara, Carcia Aylen Andrea Targa, Arevalo Roman Pablo, Rubino Pablo Augusto
Department of Neurosurgery, Hospital de Alta Complejidad en Red El Cruce, Florencio Varela, Argentina.
Department of Neurosurgery, Hospital General de Niños Pedro de Elizalde, Buenos Aires, Argentina.
J Cerebrovasc Endovasc Neurosurg. 2021 Dec;23(4):343-347. doi: 10.7461/jcen.2021.E2021.05.004. Epub 2021 Dec 17.
Inadvertent flow alterations in the parent artery during microsurgical clipping might produce postoperative ischemic complications. Intraoperative recognition of such alterations and its correction might improve operative outcomes in these patients. We present the case of a thirty-five-year-old male with an incidental small left anterior choroidal aneurysm. Microsurgical clipping induced an external compression of the anterior choroidal artery against the posterior clinoidal process which was identified in situ through surgical exploration and the loss of arterial doppler signal in the vessel. After failed attempts at clip repositioning, a posterior clinoidectomy was performed to decompress the artery. This resulted in arterial flow recovery. The aneurysm was successfully treated, and a severe ischemic complication was likely avoided. This intraoperative phenomenon has not yet been described in the literature.
显微外科夹闭过程中，母动脉意外的血流改变可能会导致术后缺血性并发症。术中识别此类改变并加以纠正，可能会改善这些患者的手术效果。我们报告一例35岁男性，偶然发现左侧脉络膜前动脉小动脉瘤。显微外科夹闭导致脉络膜前动脉受到后床突的外部压迫，通过手术探查在原位得以确认，且该血管的动脉多普勒信号消失。夹片重新定位尝试失败后，实施了后床突切除术以解除动脉压迫。这使得动脉血流得以恢复。动脉瘤得到成功治疗，且很可能避免了严重的缺血性并发症。这种术中现象尚未见文献报道。
