无症状颅内动脉瘤患者的颈动脉内膜切除术
Carotid endarterectomy in patients with asymptomatic intracranial aneurysm.
作者信息
Ladowski J S, Webster M W, Yonas H O, Steed D L
出版信息
Ann Surg. 1984 Jul;200(1):70-3. doi: 10.1097/00000658-198407000-00012.
Abstract
The patient with symptomatic extracranial carotid artery disease who, on angiography, is found to have a coexisting intracranial aneurysm presents a therapeutic dilemma. Relief of the carotid stenosis, with a potential increase in cerebral blood pressure, might increase the risk of aneurysm rupture. Conversely, repair of the aneurysm may be hazardous because of the low flow imposed by the carotid stenosis, particularly in the event of perioperative hypotension. We reviewed 19 patients treated with 20 carotid endarterectomies in the face of concurrent asymptomatic intracranial aneurysm. There were no instances of aneurysm rupture during the operation or the 30 days following operation. The literature reported to date consists of a total of 20 patients with only one incidence of aneurysm rupture in the postoperative period. We conclude that carotid endarterectomy is unlikely to precipitate rupture of an intracranial aneurysm during the operation or postoperative period.
摘要
对于症状性颅外颈动脉疾病患者，血管造影显示同时存在颅内动脉瘤时，会面临治疗困境。解除颈动脉狭窄可能会使脑血压升高，从而增加动脉瘤破裂的风险。相反，由于颈动脉狭窄导致的低血流量，尤其是在围手术期低血压的情况下，修复动脉瘤可能具有危险性。我们回顾了19例伴有无症状颅内动脉瘤的患者接受20次颈动脉内膜切除术的情况。手术期间及术后30天内均未发生动脉瘤破裂。迄今为止的文献报道共有20例患者，术后仅发生1例动脉瘤破裂。我们得出结论，颈动脉内膜切除术在手术期间或术后不太可能促使颅内动脉瘤破裂。
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