颅内外血管重建用于颅内复杂动脉瘤的治疗的论文.docVIP

　　颅内外血管重建用于颅内复杂动脉瘤的治疗的论文 【摘要】 目的 探讨应用颅内外血管重建技术治疗颅内复杂动脉瘤的技术要点。 方法 回顾性分析应用颅内外血管重建技术治疗11例颅内复杂动脉瘤的经验。行颈外动脉-大隐静脉-大脑中动脉搭桥手术5例，颈外动脉-桡动脉-大脑中动脉搭桥手术3例，颞浅动脉-大脑中动脉搭桥手术2例，枕动脉-小脑后下动脉搭桥手术1例。搭桥手术后行动脉瘤孤立术5例，载瘤动脉近心端阻断术6例。 结果 术后血管造影或3d-cta显示吻合血管通畅9例，急性闭塞1例，慢性闭塞1例；动脉瘤不显影10例，动脉瘤接受对侧椎动脉供血而需行进一步介入栓塞治疗1例。术后随访6～67个月，平均40.6个月；1例移植血管慢性闭塞病人在术后第50个月死亡，余10例病人临床表现不同程度改善，未发生再出血。 结论 颅内外血管重建结合载瘤动脉近心端阻断或动脉瘤孤立术是治疗颅内复杂动脉瘤的有效方法。　　【关键词】 脑血管重建术 颅内动脉瘤 显微外科手术 　　extra-and intra-cranial revascularization in the treatment of plex intracranial aneurysms: analysis of 11 cases 　　tong zhiyong, ent of neurosurgery, first affiliated hospital of china medical university, shenyang 110001, china 　　abstract: objective to evaluate the effectiveness of extra- and intra-cranial revascularization in the treatment of plex intracranial aneurysms and explore the surgical techniques for revascularization. methods experience in extra- and intracranial revascularization in 11 patients s iddle cerebral artery (mca) bypass ed in 5 cases, eca-radial artery-mca bypass in 3, superficial temporal artery-mca bypass in 2, and occipital artery-posterior inferior cerebellar artery bypass in 1. the parent artery occlusion (in 6 cases) or aneurysm trapping (in 5 cases) ed after the extracranial-intracranial bypass surgery. results postoperative digital subtraction angiography or three-dimensional puted tomography angiography demonstrated the patency of the grafts in 9 cases, acute occlusion in 1, and chronic occlusion in 1. aneurysm nonvisulization received blood supply from the contralateral vertebral artery required a second procedure. follo 6-67 months, mean 40.6 months. one patient died in the 50th month after the operation because of chronic occlusion of the great saphenous vein graft, and the others recovered trapping is a safe and effective approach for treating plex intracranial aneurysms. 　　key ; microsurgery 　　2002年1月～2007年12月，我们共对11例颅内复杂动脉瘤病例 （本组指海绵窦内动脉瘤、巨大血栓性动脉瘤、夹层动脉瘤和部分后循环动脉瘤等） 在治疗中运用了颅内外血管重建技术，本文重点探讨其技术要点，现报告如下。. 　　1 对象与方法