临床神经外科杂志2018，Vol.15Issue(1)：1-7,11,8.DOI:10.3969/j.issn.1672-7770.2018.01.001
床突旁动脉瘤的手术夹闭治疗
Surgical clipping of paraclinoid carotid aneurysms
摘要
Abstract
Objective To explore the clipping strategy of paraclinoid carotid aneurysms. Methods The clinical data of 11 patients with paraclinoid aneurysms who underwent aneurysm clipping in our department from February 2017 to October 2017 were analyzed retrospectively. According to modified Barami classification,2 aneurysms were type Ⅰa,3 type Ⅰb,3 type Ⅱ,3 type Ⅲa and 1 was type Ⅲb.5 aneurysms were clipped with balloon-assisted retrograde suction decompression in hybrid operation room.Clinical outcome was evaluated by Glasgow outcome scale (GOS).Results All patients received the removal of the anterior clinoid process.5 aneurysms were clipped,and 6 aneurysms were treated with clip reconstruction.Among 4 patients received a double-lumen Merci guiding balloon and retrograde suction decompression,only 2 aneurysms were deflated, whereas the other 2 aneurysms did not collapse.Intraoperative angiography or postoperative CT angiography showed 10 aneurysms were successfully obliterated,and only 1 aneurysm was residue. One patient developed decreased vision,1 patient had oculomotor paralysis.No aphasia or any limb paralysis occurred in all patients.Before discharge,all patients had good prognosis(GOS 4-5). Conclusions Clipping strategy of paraclinoid carotid aneurysms depends on classification and aneurysm size.Straight clips were used in type I,whereas fenestrated clips were used frequently in type II and III.Balloon-assisted retrograde suction decompression in hybrid operating room seems to facilitate clipping of large and giant paraclinoid aneurysms.关键词
床突旁动脉瘤/眼动脉/显微外科手术Key words
paraclinoid aneurysms/ophthalmic artery/microsurgery分类
医药卫生引用本文复制引用
徐锋,林通,徐强,黄磊,陈功,徐斌,顾宇翔,冷冰..床突旁动脉瘤的手术夹闭治疗[J].临床神经外科杂志,2018,15(1):1-7,11,8.基金项目
国家自然科学基金(81471242) （81471242）
国家重点研发计划(2016YFC0901003) （2016YFC0901003）
