一个中脑动脉大环形动脉瘤的病例,用绕道辅助的捕获手术治疗
Yusuke Sakamoto1,2, Kenko Maeda1, Masaya Takemoto1
1Department of Neurosurgery, Japan Community Health Care Organization Chukyo Hospital, Nagoya, Japan.
Nagoya journal of medical science
|June 22, 2023
概括
绕道辅助捕获手术为复杂的M1大环形动脉瘤提供了可行的解决方案,其中包括状动脉. 这种方法成功地治疗了破裂的动脉瘤,保持了关键的血液供应,并导致了有利的患者结果.
科学领域:
- 神经外科 神经外科
- 血管神经学 血管神经学
- 脑血管外科 脑血管外科
背景情况:
- M1大环形动脉瘤由于其大小,位置和频繁涉及必不可少的穿孔动脉,如晶状动脉 (LSAs),造成了重大治疗挑战.
- 目前对这些复杂动脉瘤的治疗策略尚未确定,需要探索创新的外科手术技术.
研究的目的:
- 报告一个成功治疗破裂的大M1环形动脉瘤的病例,使用绕道辅助捕获手术.
- 突出这一技术的可行性和有效性,以保持LSA血液供应并实现有利的结果.
主要方法:
- 一名47岁的男性患者患有M1环形动脉瘤破裂,涉及LSAs,经历了表面动脉 (STA) -M2绕道创建,随后是动脉瘤捕获.
- 数字减去血管造影用于诊断和手术内评估. 手术干预的重点是保护中侧和侧侧LSAs.
主要成果:
- 绕道辅助的捕获手术在技术上是成功的,保留了中间和侧面的LSAs.
- 由于中部LSA血栓形成,患者在术后经历过渡性左半,但在康复后显著恢复,在五个月后实现独立的日常功能.
结论:
- 绕道辅助捕获手术是复杂的M1大环形动脉瘤的有价值的治疗选择,特别是当涉及LSA时.
- 个性化治疗计划,考虑预防再出血,远端输液和穿孔器保存,对于管理这些具有挑战性的脑血管病变至关重要.
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