Tsukahara T, Wada H, Satake K, Yaoita H, Takahashi A
Department of Neurosurgery, Hokushin General Hospital, Nagano, Japan.
Neurosurgery. 1995 May;36(5):914-9; discussion 919-20. doi: 10.1227/00006123-199505000-00004.
Five patients with spontaneous dissecting vertebral aneurysms presenting with subarachnoid hemorrhage were treated with endovascular proximal balloon occlusion after a successful balloon Matas' test. Occlusion was performed in the extracranial portion of the vertebral artery after the potentially dangerous period of cerebral vasospasm. Two patients rebled preoperatively during the waiting period. Although angiograms demonstrated residual aneurysmal dilatation for four of the five patients, postoperative hemorrhages or progression of the dissection were not observed during the 19- to 48-month follow-up period. Only one patient experienced transient postoperative ischemic complication. Although the timing of the procedure and the site of occlusion remain controversial, proximal balloon occlusion of the vertebral artery appears to be a safe and effective therapy for patients with dissecting vertebral aneurysms presenting with subarachnoid hemorrhages. This method provides an important, less invasive alternative for this condition.
5例因蛛网膜下腔出血而出现自发性椎动脉夹层动脉瘤的患者，在球囊Matas试验成功后，接受了血管内近端球囊闭塞治疗。在脑血管痉挛的潜在危险期过后，在椎动脉的颅外部分进行闭塞。2例患者在等待期术前再次出血。尽管血管造影显示5例患者中有4例存在残留动脉瘤扩张，但在19至48个月的随访期内未观察到术后出血或夹层进展。只有1例患者出现短暂的术后缺血性并发症。尽管手术时机和闭塞部位仍存在争议，但椎动脉近端球囊闭塞对于因蛛网膜下腔出血而出现椎动脉夹层动脉瘤的患者似乎是一种安全有效的治疗方法。该方法为这种情况提供了一种重要的、侵入性较小的替代方案。
