床突旁颈内动脉瘤的手术治疗

探讨床突旁动脉瘤的分型，以及各型的手术特点，以提高该动脉瘤的手术疗效。回顾性分析ｐ－ＩＣＡＡ１８例，其中颈眼动脉型７例；垂体上动脉型７例；颈内动脉腹侧型４例。手术方法包括动动脉瘤夹闭术１３例交；动脉瘤孤立术３例；夹闭＋包裹术２例；颈总动有吉轧＋动脉瘤包裹１例。

Classification and surgery for paraclinoid carotid artery aneurysms

Objective: To discuss the classification of paraclinoidal carotid artery aneurysms (p ICAA) and corresponding operative techniques to improve its surgical effectiveness. Methods: Retrospective analysis had been made of 18 patients with p ICAA classified into 3 types: carotid ophthalmic artery aneurysms in 7 cases, superior hypophyseal aneurysms in 7 cases and ventral paraclinoid carotid aneurysms in 4 cases.All were operated with clipping of neck of aneurysm in 13 cases ,trapping of aneurysms in 3 cases,cliping combined with wrapping in 2 cases and wrapping of aneurysm combined with ligation of common carotid artery in 1 case. During the operation resection of the anterior clinoid process and opening of the optic canal have been applied in 16 cases,temporary artery occlusion and trapping of aneurysms or intra aneurysm decompression by invention technique permitting outstanding aneurysm deflation had been employed in 14 cases. Results: Outcome were considered good in 15 patient(83.1%), without operative mortality. Of them, v ICCA was operated on more difficult with relatively poor result. Conclusion: 1.Our classification of p-ICCA is useful. 2.During the operation there are some key objectives: 1) establishment of proximal artery control. 2)adequate exposure of the proximal neck. 3) temporary trapping of aneurysm and intra aneurysm decompression. 4) choice of clips and clipping methods.