威利斯圆的动态适应性的模式,以响应主要分支动脉覆盖的流量转换器
Felipe Ramirez-Velandia1, Emmanuel Mensah1, Mira Salih1
1Neurosurgical Service, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
World neurosurgery
|October 21, 2024
概括
威利斯圆在脑动脉瘤的流量转移器 (FD) 治疗后显示出了显著的可塑性. 血管口径调整以保持大脑的血液流动,展示了适应性血管解剖学.
科学领域:
- 神经内血管外科手术是一种神经内血管手术.
- 脑血管解剖学 脑血管解剖学
- 医学成像分析分析 医学成像分析
背景情况:
- 威利斯圆的可塑性在脑血管疾病中至关重要.
- 流量转移 (FD) 是一种治疗内动脉瘤的内血管技术.
- 了解FD后的血管变化对于患者的治疗结果至关重要.
研究的目的:
- 在流量转移器处理后调查威利斯圆的解剖学和血液动力学可塑性.
- 为了确定血管口径变化的独特模式,以响应FD覆盖主要大脑动脉的覆盖.
- 评估威利斯圆的适应机制,以维持远端输液.
主要方法:
- 从2013年至2023年期间,从622名用FD治疗的患者获得数字减去血管图的回顾性分析.
- 测量血管直径,包括由支架和相邻动脉覆盖的血管直径.
- 在49名患者的最后一次成像随访时评估血管学变化.
主要成果:
- 在威利斯圆圈中发现了四种不同的血管图形变化模式.
- 在逆侧ACA覆盖后,观察到前脑动脉 (ACA) 的口径增加.
- 后部通讯动脉 (PComA) 的扩大发生在PCA起源的覆盖之后.
- 在前沟通动脉动脉瘤治疗后,ACA的A1段的适应性被观察到.
结论:
- 威利斯圆在流量转移器治疗后表现出显著的血液动力学和解剖学可塑性.
- 这些适应性变化对于在主要分支覆盖之后保护远部地区的血液流动至关重要.
- 流量转移可以在威利斯圆圈内诱导补偿性血管重塑.
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