内绕道的指示和结果:系统性审查和元分析
Yasmin Sadigh1, Yvette de Haan2, Eva Joëlle Haasdijk2
1Department of Neurosurgery, Erasmus MC Stroke Center, Erasmus MC University Medical Centre, Rotterdam, The Netherlands; Center for Complex Microvascular Surgery, Erasmus MC University Medical Centre, Rotterdam, The Netherlands.
World neurosurgery
|July 23, 2025
概括
内直接绕道手术是莫亚莫亚血管病变和复杂动脉瘤的相关治疗方法. 它是狭性闭塞性疾病的救援选择,结果因适应症而异.
科学领域:
- 神经外科 神经外科
- 血管外科 血管外科
- 神经学 神经学
背景情况:
- 内直接绕道手术是一种复杂的神经外科手术程序.
- 迹象和结果需要全面分析.
研究的目的:
- 系统地审查和元分析内直接绕道手术的指示,选择标准和结果.
- 提供当前手术实践和患者结果的概述.
主要方法:
- 从Embase,Medline,Web of Science,Google Scholar和Cochrane的研究进行了系统的审查和元分析.
- 使用随机效应模型分析通透性,神经复杂症,临床结果和死亡率.
- 包含了142篇文章,报告了绕道手术的各种迹象.
主要成果:
- 最常见的指标是静脉封闭性疾病 (106项研究),临床结果不佳的比例为9%,死亡率为3.5%.
- 莫亚莫亚血管病 (41项研究) 显示出5.5%的不良结果和0.6%的死亡率.
- 其他迹象包括紧急绕道,破裂和复杂的未破裂动脉瘤.
结论:
- 内旁路手术仍然是莫亚莫亚血管病变的重要治疗选择.
- 它是狭性疾病中血液动力学妥协的关键救援疗法.
- 该程序也适用于其他治疗不适合的复杂动脉瘤.
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