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经过手术疏散后的中脑膜大动脉通透性,用于慢性腹腔内血瘤
Georgios S Sioutas1, Oleg Shekhtman1, Mert Marcel Dagli1
1Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Neurosurgical review
|April 9, 2024
概括
中脑膜动脉栓塞 (MMAE) 即使在先前的手术后,对于慢性亚皮质血瘤 (CSDH) 也有效. 虽然骨切割可以影响MMA通透度,但无论手术史如何,结果仍然相似.
科学领域:
- 神经外科 神经外科
- 干预性神经辐射学
- 血管干预放射学 血管干预放射学
背景情况:
- 慢性亚皮血瘤 (CSDH) 管理通常涉及高复发率的外科疏散.
- 中脑膜动脉栓塞 (MMAE) 是一种潜在的治疗方法,但其在先前手术后的疗效仍有争议.
- 之前的研究已经排除了先前切割的患者,理由是对MMAE获取和有效性的担忧.
研究的目的:
- 研究先前手术疏散对中脑膜动脉 (MMA) 穿透性的影响及其对CSDH患者MMAE结局的影响.
- 为了确定先前的切除术或洞手术是否会影响MMAE对CSDH的成功.
主要方法:
- 在2019-2022年期间,对109个MMAE CSDH程序进行了回顾性分析.
- 根据MMAE是否进行了预先或经过先前的外科疏散 (骨切除或洞) 后,患者被分类.
- 使用六分级评分表来评估MMA通透度,并将子组之间的结果进行比较.
主要成果:
- 在骨切割组中,MMA通透率降低了,特别是在远端前部划分,与骨切割区域相关.
- 血瘤厚度的减少,需要进行手术救援,以及功能性结局,在接受预先MMAE的患者与接受过手术的患者之间没有差异.
- MMA通透度,疏散方法和切区域没有显著影响患者的结果.
结论:
- 不管之前的手术史,包括洞疏散,MMAE是CSDH的可行的治疗选择.
- 虽然骨切割可以影响远端MMA通透度,但这并不意味着临床结果较差.
- 这些发现支持在更广泛的CSDH患者群体中使用MMAE,并可能为未来的临床试验标准提供信息.
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