Pelz D M, Viñuela F, Fox A J, Drake C G
J Neurosurg. 1984 Mar;60(3):560-5. doi: 10.3171/jns.1984.60.3.0560.
The clinical and angiographic records were reviewed for 71 patients with giant aneurysms of the posterior circulation, who underwent therapeutic occlusion of the basilar artery or both vertebral arteries. This treatment is used when the aneurysm neck cannot be surgically clipped, and occlusion of the parent artery is performed to initiate thrombosis within the lumen. In these cases, collateral blood flow to the brain stem is supplied mainly by the posterior communicating arteries. Consequently, their angiographic morphology (patency, size, and number) is demonstrated as a preoperative indicator of whether the patient will be able to tolerate vertebrobasilar occlusion. Vertebral angiograms with carotid artery compression (the Allcock test) will often be needed to provide this information. The data relating posterior communicating artery morphology to clinical outcome in 71 cases of attempted vertebrobasilar occlusion are presented. The use and accuracy of carotid artery compression studies are also discussed. It is essential for the radiologist to supply the neurosurgeon with this valuable information in every case of giant posterior circulation aneurysm.
对71例后循环巨大动脉瘤患者的临床和血管造影记录进行了回顾，这些患者接受了基底动脉或双侧椎动脉的治疗性闭塞。当动脉瘤颈无法通过手术夹闭时，采用这种治疗方法，通过闭塞供血动脉来启动管腔内血栓形成。在这些病例中，脑干的侧支血流主要由后交通动脉供应。因此，它们的血管造影形态（通畅性、大小和数量）被视为患者是否能够耐受椎基底动脉闭塞的术前指标。通常需要进行压迫颈动脉的椎动脉血管造影（Allcock试验）来提供这一信息。本文展示了71例尝试进行椎基底动脉闭塞病例中后交通动脉形态与临床结果的相关数据。还讨论了颈动脉压迫研究的应用及准确性。对于放射科医生来说，在每一例后循环巨大动脉瘤病例中为神经外科医生提供这一有价值的信息至关重要。
