对先前盘绕的后上方突出的前交通动脉瘤进行开口剪切：我是怎么做的。

IF 1.9 3区医学 Q3 CLINICAL NEUROLOGY Acta Neurochirurgica Pub Date : 2024-10-05 DOI:10.1007/s00701-024-06279-5

R. Chase Ransom, Stephen Graepel, Giuseppe Lanzino, Lorenzo Rinaldo

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引用次数: 0

摘要

背景：前交通动脉（ACOM）动脉瘤是动脉瘤性蛛网膜下腔出血最常见的动脉瘤之一（《未破裂颅内动脉瘤国际研究 I》（N Engl J Med 339：1725-1733，1998 年），Wiebers（《柳叶刀》362：103-110，2003 年））。手术切除后上方突出的 ACOM 动脉瘤具有挑战性，因为同侧的 A2 会干扰夹子的轨迹，ACOM 穿孔血管也会阻挡视线。腔内线圈会进一步增加手术难度：方法：介绍相关的手术解剖，并配有插图。结论：结论：手术夹除后上方突出的 ACOM 动脉瘤可能需要复杂的夹子配置。我们介绍了通过眶上外侧开颅手术和栅栏式串联夹持术对后上方突出的 ACOM 动脉瘤进行夹持的关键步骤。

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Fenestrated clipping of previously coiled posterior-superiorly projecting anterior communicating artery aneurysms: How I do it

Background

Anterior communicating artery (ACOM) aneurysms are among the most common aneurysms associated with aneurysmal subarachnoid hemorrhage (International Study of Unruptured Intracranial Aneurysms I (N Engl J Med 339:1725-1733, 1998), Wiebers (Lancet 362:103-110, 2003)). Surgical clipping of posterior-superiorly projecting ACOM aneurysms can be challenging, as the ipsilateral A2 can interfere with clip trajectory and ACOM perforating vessels obstructed from view. Intraluminal coils can further increase the difficulty of the procedure.

Method

The relevant surgical anatomy with illustration is presented. A video detailing our technique on an illustrative case is provided.

Conclusion

Surgical clipping of posterior-superiorly projecting ACOM aneurysms can require complex clip configurations. We describe the key steps of posterior-superiorly projecting ACOM aneurysm clipping through a lateral supraorbital craniotomy and fenestrated tandem clipping.

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来源期刊

Acta Neurochirurgica 医学-临床神经学

CiteScore

4.40

自引率

4.20%

发文量

342

审稿时长

1 months

期刊介绍： The journal "Acta Neurochirurgica" publishes only original papers useful both to research and clinical work. Papers should deal with clinical neurosurgery - diagnosis and diagnostic techniques, operative surgery and results, postoperative treatment - or with research work in neuroscience if the underlying questions or the results are of neurosurgical interest. Reports on congresses are given in brief accounts. As official organ of the European Association of Neurosurgical Societies the journal publishes all announcements of the E.A.N.S. and reports on the activities of its member societies. Only contributions written in English will be accepted.