位于小角度动脉分叉处小型动脉瘤手术夹闭

目的探讨位于小角度动脉分叉处小型动脉瘤特点及手术夹闭方法。方法对2007年1月～2011年7月期间收治的5例体积≤3mm,生长在夹角<45°2个动脉分叉根部动脉瘤进行回顾性分析,观察动脉瘤生长特点,结合动脉瘤夹的性能,从几何和力学角度探索手术夹闭方法。结果这种动脉瘤常与相邻最近一个分支动脉壁粘连;并且位于两分叉动脉根部,不易将瘤颈部分离出能够通过动脉瘤夹叶片的空间,不能够按照常规方法夹闭。结论在游离困难时不必完全游离动脉瘤,采用小弯形夹平行一侧分支的方法夹闭动脉瘤颈及对侧分支壁少部分可以获得满意效果。

Surgical clipping of small aneurysm at arterial bifurcation with small included angle

Objective To explore characteristics of small aneurysm at arterial bifurcation with small included angle and surgical clipping thereof. Method The clinical data of 5 patients with aneurysms at root of arterial bifurcation, which were at most 3 mm in volume and the included angles of the arterial bifurcations smaller than 45 degree were analyzed retrospectively. Development characteristics of the aneurysms were observed and surgical clipping was studied from the standpoint of geometry and mechanism based on the characteristics and aneurysm clip performance. Results Such aneurysms usually adheres to wall of the nearest artery and located at root of the arterial bifurcation, it was difficult to make enough space at aneurysm neck for aneurysm clipping. Normal clipping method is not applicable. Conclusions It was not necessary to completely dissociate the aneurysms when difficulty to do so. The aneurysms can be clipped satisfyingly by clipping the neck and small part of an artery parallel to the other artery.