术中荧光素钠视频血管造影与术后影像学检查在评估颅内动脉瘤夹闭效果中的对比分析
A Comparative Analysis between Intraoperative Fluorescein Sodium Videoangiography and Postoperative Imaging for Evaluating Clipped Intracranial Aneurysms.
作者信息
Dellaretti Marcos, Soares André Guimarães, Lima Allan Douglas Oliveira, Melo Matheus Tavares, Acherman Natalia Dilella, Almeida Júlio Cesar, Gonçalves Vitor Deus Rocha Ribeiro, Costa Bruno Silva
机构信息
Department of Neurosurgery and Neurology, Santa Casa de Belo Horizonte, Belo Horizonte, Brazil.
Department of Surgery, Federal University of Minas Gerais, Belo Horizonte, Brazil.
出版信息
Asian J Neurosurg. 2025 May 26;20(3):556-563. doi: 10.1055/s-0045-1809049. eCollection 2025 Sep.
INTRODUCTION
The evaluation of clipped intracranial aneurysms postoperatively is crucial for successful surgical treatment and minimizing risks such as residual aneurysms and complications. Fluorescein sodium videoangiography (FL-VA) has been introduced to aid in this assessment, but comparative studies with postoperative imaging remain limited.
MATERIALS AND METHODS
A prospective observational study was conducted on 57 patients with 64 intracranial aneurysms who underwent surgery between December 2021 and September 2022. FL-VA was performed, followed by postoperative computed tomography angiography (CTA). Discordance between FL-VA and CTA findings was analyzed statistically.
RESULTS
FL-VA showed complete occlusion in 57 out of 61 aneurysms (93.4%), with 10 cases of discordance identified in postoperative CTA. One patient showed a neck remnant in FL-VA, but CTA revealed a residual aneurysm. Another patient displayed neck remnant and stenosis in branching vessels on CTA, not identified by FL-VA. Additionally, five aneurysms had neck remnants, and three had stenosis in branching vessels, detected in CTA but missed in FL-VA. Statistical analysis did not reveal significant associations between discordance and studied factors.
CONCLUSION
FL-VA shows potential as an effective intraoperative assessment tool for clipped intracranial aneurysms, although further research is needed to establish its definitive efficacy and reliability compared with other modalities.
引言
术后评估夹闭的颅内动脉瘤对于手术治疗的成功以及将诸如残留动脉瘤和并发症等风险降至最低至关重要。荧光素钠视频血管造影术(FL-VA)已被引入以辅助这一评估,但与术后成像的比较研究仍然有限。
材料与方法
对2021年12月至2022年9月期间接受手术的57例患有64个颅内动脉瘤的患者进行了一项前瞻性观察研究。进行了FL-VA检查,随后进行了术后计算机断层血管造影(CTA)。对FL-VA和CTA结果之间的不一致进行了统计学分析。
结果
FL-VA显示61个动脉瘤中有57个完全闭塞(93.4%),术后CTA发现10例不一致情况。1例患者在FL-VA中显示颈部残留,但CTA显示有残留动脉瘤。另1例患者在CTA上显示颈部残留和分支血管狭窄,FL-VA未发现。此外,5个动脉瘤有颈部残留,3个分支血管有狭窄,CTA检测到但FL-VA未发现。统计学分析未显示不一致与研究因素之间存在显著关联。
结论
FL-VA显示出作为夹闭颅内动脉瘤有效术中评估工具的潜力,尽管与其他方式相比,还需要进一步研究以确定其确切疗效和可靠性。
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