Massoud T F, Guglielmi G, Viñuela F, Duckwiler G R
Department of Radiological Sciences, University of California at Los Angeles Medical Center 90024.
Surg Neurol. 1994 Jun;41(6):462-7. doi: 10.1016/0090-3019(94)90008-6.
Moyamoya disease (MMD) often presents with subarachnoid hemorrhage due to rupture of saccular aneurysms. We describe three patients with cerebrovascular features of MMD in whom four aneurysms of the posterior circulation were endovascularly occluded by electrothrombosis using the recently developed Guglielmi electrically detachable coils (GDC). Near total occlusion was achieved in three aneurysms. Subtotal occlusion was achieved in one aneurysm. This patient developed complications related to the neuroleptic anesthesia administered for the procedure. The particular hazards of anesthesia and aneurysmal surgery in MMD are discussed, and comparison is made with the benefits of using the GDC. Initial experience suggests that this endovascular approach is safe and effective in the treatment of saccular aneurysms in MMD. However, follow-up is necessary to assess long-term persistence of aneurysm obliteration.
烟雾病（MMD）常因囊状动脉瘤破裂而出现蛛网膜下腔出血。我们描述了3例具有烟雾病脑血管特征的患者，其中后循环的4个动脉瘤使用最近研发的 Guglielmi 可电解脱弹簧圈（GDC）通过电血栓形成法进行了血管内闭塞。3个动脉瘤实现了几乎完全闭塞，1个动脉瘤实现了部分闭塞。该患者出现了与手术中使用的神经安定麻醉相关的并发症。讨论了烟雾病麻醉和动脉瘤手术的特殊风险，并与使用GDC的益处进行了比较。初步经验表明，这种血管内治疗方法在治疗烟雾病囊状动脉瘤方面是安全有效的。然而，需要进行随访以评估动脉瘤闭塞的长期持续性。
