用吲哚菁绿视频血管造影术夹闭类旁动脉瘤的初步结果：越南的单中心经验。

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery Pub Date : 2025-03-24 DOI:10.1016/j.wneu.2025.123928

Anh Minh Nguyen , Hai Hong Do , Nghia Huynh Trung , Dung Hoang Tuan Bui

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引用次数: 0

摘要

背景：治疗未破裂的伞状动脉瘤主要有两种方法：血管内手术和手术夹闭。术中吲哚菁绿视频血管造影术（ICG-VA）等最新进展提高了手术中心在不进行术中成像的情况下进行夹闭手术的安全性。本研究是越南的一项单中心经验，旨在评估使用 ICG-VA 对椎旁动脉瘤进行手术的初步结果：我们对 2019 年至 2023 年期间在胡志明市大学医学中心接受剪切手术的 53 例未破裂椎旁动脉瘤患者进行了回顾性研究：所有患者在 3 个月的随访中均获得了良好的功能结果，无死亡病例，60% 的视觉症状在术后得到改善。A 组（未使用 ICG-VA）和 B 组（使用 ICG-VA）在神经系统并发症和放射学结果方面没有明显的统计学差异。只有在 CT 扫描中发现的缺血率存在统计学意义上的差异（P=0.031）。未完成剪切的比例为18.9%，未完成剪切的唯一显著因素是最大直径较大（P=0.044）：结论：手术切除未破裂的椎旁动脉瘤是一种安全可行的治疗方法，可以获得良好的神经功能预后。应用 ICG-VA 可提供术中实时可视，并有可能减少并发症。该位置动脉瘤的不完全夹闭率仍是一个需要克服的挑战，有几个因素可以预测这一重要问题。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Preliminary Results of Paraclinoid Aneurysm Clipping With Indocyanine Green-Video Angiography: A Single-Center Experience in Vietnam

Background

There are 2 main treatments for unruptured paraclinoid aneurysms: endovascular procedures and surgical clipping. Recent advancements such as intraoperative indocyanine green video angiography (ICG-VA) are improving the safety of clipping procedure in the surgical center without intraoperative imaging. This study is a single-center experience in Vietnam to evaluate the preliminary result of a surgical series in paraclinoid aneurysms with ICG-VA.

Methods

We performed a retrospective study of 53 unruptured paraclinoid aneurysms who underwent clipping surgery from 2019 to 2023 at the University Medical Center, Ho Chi Minh City.

Results

All patients achieved good functional outcomes at 3 months follow-up with no mortality, and 60% of visual symptoms improved postoperatively. There were no statistically significant differences in neurological complications and radiological results between groups A (no ICG-VA) and B (using ICG-VA). Statistically significant differences were only observed in the rate of ischemia detected on computed tomography scan (P = 0.031). The rate of incompleted clipping was 18.9%, with the only significant factor for incompleted clipping being a larger maximal diameter (P = 0.044).

Conclusions

Surgical clipping of unruptured paraclinoid aneurysms is a safe and feasible treatment, and good neurological outcomes can be achieved. Applying ICG-VA has provided intraoperative real-time visualization and the potential to decrease complications. The incomplete clipping rate of aneurysms in this position is still a challenge to overcome and several factors can predict this important issue.

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来源期刊

World neurosurgery CLINICAL NEUROLOGY-SURGERY

CiteScore

3.90

自引率

15.00%

发文量

1765

审稿时长

47 days

期刊介绍： World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal''s mission is to: -To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care. -To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide. -To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients. Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS