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治疗内动脉动脉瘤的最佳临时闭塞时间

Nakao Ota¹, Yasuhiro Hagiwara², Fozia Saeed^3,4

¹Department of Neurosurgery, Sapporo Teishinkai Hospital, 3 - 1, Higashi 1, Kita 33, Higashi-Ku, Sapporo, Hokkaido, 065 - 0033, Japan. nakao1980@gmail.com.

Neurosurgical review

|April 24, 2025

概括

在内动脉动脉瘤治疗中,在5分钟以下的暂时封闭是最安全的,最大限度地降低了DWI变化的风险. 较长的闭塞时间增加了穿孔器梗塞和潜在的认知功能障碍的风险.

科学领域:

神经外科神经外科
血管神经学血管神经学
神经辐射学神经辐射学

背景情况:

术后扩散加权成像 (DWI) 超强度与动脉瘤治疗后的认知功能障碍有关.
微手术剪切对于内动脉 (ICA) 动脉瘤是有效的,通常需要暂时封闭以进行安全的剖析.
尽量减少DWI变化对于改善患者的治疗结果和减少并发症至关重要.

研究的目的:

为了确定ICA动脉瘤的微手术剪切过程中暂时封闭的最佳持续时间.
分析与术后DWI超强度相关的因素,特别是穿孔动脉梗塞.

主要方法:

对267名因ICA动脉瘤而接受微手术剪切的患者进行了回顾性分析.
临床结果的评估和与术后DWI超强度的相关性.
饮酒过度强度的分类为穿孔动脉梗塞或"其他"梗塞.

主要成果:

在手术后的DWI超强度在14.2%的病例中被观察到 (38/267).
在较长的临时闭塞持续时间和穿孔器心脏病发作 (OR:每分钟1.29) 之间发现了显著的关联.
在5分钟以下的暂时封闭显示了DWI变化的最低风险;风险在12.5分钟以后显著增加.

结论:

暂时性闭塞,虽然对于安全的ICA动脉瘤剪切至关重要,但如果长时间持续,可能导致DWI超强度.
超过12.5分钟的闭塞时间与穿孔器心脏病发作的风险大大增加有关.
执行不到5分钟的临时闭塞被强调为治疗ICA动脉瘤的安全间隔,最大限度地减少神经系统并发症.

关键词:

脑梗塞脑梗塞脑梗塞剪切剪切剪切剪切扩散加权成像技术的使用.内动脉动脉瘤内动脉动脉瘤逆行吸入和解压缩.暂时封闭时间暂时封闭时间

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