[与莫亚莫亚血管病变相关的动脉瘤 (临床病例) ]
M Sh Amiralieva1,2, K S Ovsyannikov3, K Yu Orlov1
1Federal Center of Brain Research and Neurotechnology, Moscow, Russia.
Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko
|November 27, 2025
概括
与莫亚莫亚血管病变 (AA-MMA) 相关的动脉动脉瘤存在独特的外科手术挑战. 这项研究突出了对破裂的AA-MMA的成功结合内血管和外科重血管化策略,改善了患者的治疗结果.
科学领域:
- 神经外科 神经外科
- 血管神经学 血管神经学
- 干预性神经放射学 干预性神经放射学
背景情况:
- 与莫亚莫亚血管病变 (AA-MMA) 相关的动脉动脉瘤发生率明显高于一般人群.
- AA-MMA断裂具有很高的风险 (高达90%),标准治疗面临相当大的并发症率 (25%的剪切,26%的内血管策略).
- 由于AA-MMA的复杂性和相关风险,有效的治疗算法至关重要.
研究的目的:
- 呈现与莫亚莫亚血管病变 (AA-MMA) 相关的动脉动脉瘤破裂的罕见临床病例.
- 讨论和说明AA-MMA的外科和内血管治疗选择.
主要方法:
- 介绍了两个破裂AA-MMA的病例.
- 案例1:与MMA (苏苏基III) 治疗的远端晶状体动脉动脉瘤,以栓塞治疗,然后再血管化.
- 案例2:ACA-AcomA复合动脉瘤与相反的MMA经过微手术剪切和再血管化治疗.
主要成果:
- 在这两种情况下,通过结合的内血管和微手术技术,成功切除了动脉瘤.
- 延迟复血管化改善了治疗后的大脑输液.
- 在长期随访 (2年和9年) 期间,这两名患者都没有出现复发性中风.
结论:
- AA-MMA是一种复杂的脑血管病理,需要专门的管理.
- 对AA-MMA的标准手术方法与高并发症风险有关.
- 仔细的手术前规划,考虑到MMA的致病特征,对于成功的AA-MMA治疗至关重要.
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