通过脚动脉牺牲进行手术前瘤栓塞,用于有症状的脊髓动脉瘤骨囊:说明性病例
Jonathan Davis1, Maya Langman2, Erickson F Torio2
1Medical College of Wisconsin, Milwaukee, Wisconsin.
Journal of neurosurgery. Case lessons
|March 3, 2025
概括
脊髓动脉瘤骨囊 (ABCs) 的术前栓塞可以减少血液损失并改善手术结果. 这一策略虽然有争议,但在两个胸部ABC病例中证明了安全性和有效性,导致了完全切除和良好的神经恢复.
科学领域:
- 神经外科 神经外科
- 干预性放射学 干预性放射学
- 在瘤学瘤学.
背景情况:
- 脊髓动脉瘤骨囊 (ABCs) 由于高血管性和关键解剖近距离,存在重大管理挑战.
- 大型,有症状的胸部ABC需要创新的治疗方法.
研究的目的:
- 评估手术前栓塞的安全性和有效性,以治疗具有症状的大型胸脊动脉瘤骨囊.
- 评估栓塞对手术期间输血和术后神经结果的影响.
主要方法:
- 术前栓塞以脚动脉牺牲为目标,使用线圈栓塞进行.
- 为了最大限度地降低风险,采用激发性甲索赫西塔尔和利多卡因测试进行手术期间的监测.
- 随后进行了手术切除,以实现完全切除瘤.
主要成果:
- 两位患者都成功地进行了完整的瘤切除.
- 在手术期间流失的血液比预期的要少.
- 没有观察到与栓塞相关的不良影响.
- 患者在术后经历了神经功能显著恢复.
结论:
- 术前栓塞是选择脊柱ABC的潜在有益策略,尽管关于其指示的争议仍在继续.
- 减少血液流失和提高手术安全的好处可能超过与脊柱血管造影和栓塞相关的风险.
- 这种方法促进了在所述病例中最大限度的安全瘤切除与最小的神经病发率.
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