借助颞浅动脉-大脑后动脉和颞浅动脉-小脑上动脉双搭桥显微手术治疗巨大血栓性基底动脉-小脑上动脉动脉瘤:二维手术视频。

IF 1.7 4区 医学 Q3 CLINICAL NEUROLOGY
Operative Neurosurgery Pub Date : 2025-02-01 Epub Date: 2024-07-05 DOI:10.1227/ons.0000000000001257
Nuno Cubas Farinha, Nakao Ota, Juan Carlos Gomez-Vega, Tomomasa Kondo, Kosumo Noda, Rokuya Tanikawa
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引用次数: 0

摘要

巨型血栓性后循环动脉瘤是一种罕见病变,其自然病史与高发病率和高死亡率相关。1-6 无论是显微手术还是血管内治疗(ET),治疗风险都很高。ET 更容易进入,但复发率高,而显微手术治疗更难进入,但治疗效果更持久。7-13 一位 47 岁的女性因右侧巨大血栓性基底动脉-小脑上动脉(BA-SCA)动脉瘤埋在脑干并伴有周围水肿而出现左侧偏瘫。由于穿孔器闭塞的风险和 ET 的高复发率,我们选择了借助颞浅动脉-大脑后动脉(STA-PCA)和 STA-SCA 双保护性旁路的显微外科夹闭手术。患者同意该手术并同意公布其图像。首先,我们进行了颧弓切除的翼状开颅手术,暴露了右侧 PCA、右侧 SCA、BA 和动脉瘤颈。然后,为了实施安全的保护性STA-PCA分流术,有必要进行部分颞叶切除术,以避免损伤PCA穿孔分支。随后,剪除 BA-SCA 动脉瘤。剪除动脉瘤后,又进行了STA-SCA分流术,以防止之后可能出现的SCA闭塞。患者的左侧偏瘫和右侧眼球运动麻痹症状最初有所恶化,但经过康复治疗后已痊愈,术后 6 个月无任何障碍。术后造影证实动脉瘤已被排除,没有缺血性病变,脑干水肿也已恢复。保护性旁路是一种有用的技术,可改善某些巨大后循环动脉瘤的显微外科治疗效果。本报告已获我院伦理委员会批准。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Microsurgical Treatment of a Giant Thrombosed Basilar Artery-Superior Cerebellar Artery Aneurysm With the Aid of Double Bypass Superficial Temporal Artery-Posterior Cerebral Artery and Superficial Temporal Artery-Superior Cerebellar Artery: 2-Dimensional Operative Video.
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来源期刊
Operative Neurosurgery
Operative Neurosurgery Medicine-Neurology (clinical)
CiteScore
3.10
自引率
13.00%
发文量
530
期刊介绍: Operative Neurosurgery is a bi-monthly, unique publication focusing exclusively on surgical technique and devices, providing practical, skill-enhancing guidance to its readers. Complementing the clinical and research studies published in Neurosurgery, Operative Neurosurgery brings the reader technical material that highlights operative procedures, anatomy, instrumentation, devices, and technology. Operative Neurosurgery is the practical resource for cutting-edge material that brings the surgeon the most up to date literature on operative practice and technique
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