不同术式颅内外血管搭桥在颅内动脉瘤治疗中的应用

目的 探讨不同术式颅内外血管搭桥术在颅内动脉瘤治疗中的作用。方法回顾性分析9例颅内动脉瘤患者闭塞载瘤动脉前行颅内外血管搭桥术的临床资料,载瘤动脉远端侧支循环代偿状况,不同术式颅内外血管搭桥术的手术方法等和方法。结果9例颅内动脉瘤患者载瘤动脉远端侧支循环代偿均不良,经多途径颅内外血管搭桥后闭塞了载瘤动脉,无载瘤动脉远端脑缺血现象发生结论对于载瘤动脉远端侧支循环代偿不良的患者,闭塞载瘤动脉前需根据其远端的脑血流需求选择不同途径的颅内外血管搭桥术,进行载瘤动脉远端的血流重建。

Different methods of intracranial-extracranial bypass surgery for the treatment of intracranial aneurysms

Objective To investigate the effects and methods of intracranial-extracranial(IC-EC)bypass surgery in the treatment of intracranial aneurysms.Methods The clinical material of 9 cases,who performed IC-EC bypass surgery before occlusion of the parental arteries of intracranial aneurysms,was studied retrospectively,especially how to evaluate the co-lateral circulation of the parental arteries and how to select the different methods of IC-EC bypass surgery.Results The co-lateral circulation in 9 cases was not enough to meet the need of the cerebral blood flow after occlusion of the parental arteries of the aneurysms.Revascularization by different methods of IC-EC bypass surgery and then occlusion of the parental arteries,ischemia in the brain area feeding by occluded parental arteries of the aneurysms did not occurred.Conclusion When the co-lateral circulation of the parental arteries of intracranial aneurysm is not enough,the revascularization by different methods of IC-EC bypass surgery is needed before occlusion of these arteries.