脑血管造影在颅内动脉瘤夹闭术后的应用

Effective of cerebral angiography after clipping of cerebral aneurysm

１９９１年１月～１９９４年３月，我们对９１例病人共９９个脑动脉瘤夹闭术后常规行脑血管造影。造影发现动脉瘤残留者５例（５％），动脉瘤完全未夹闭者１例（１％），载瘤动脉闭塞者１２例（１２％）。手术后造成动脉瘤残留的原因主要与动脉瘤的部位、大小、蒂的宽窄以及手术中动脉瘤的破裂等有密切关系。术者对动脉瘤以及载瘤动脉是否被夹闭往往有误，故不能替代手术后的脑血管造影。动脉瘤残留和血管闭塞术后可以是无症状的，必需靠术后行脑血管造影发现，这样才能对其进行必要的和适当的处理，从而降低脑动脉瘤术后的死亡率和致残率。

Cerebral angiographies were done routinely in 99 cerebral aneurysms of 91 patients after clipping of the aneurysms in the Neurosurgery Department of Beijing Tiantan Hospital,from January 1991 to March 1994.It revealed that there were five cases of residual aneurysms(5%),one case whose aneurysm failed to be clipped at all(1%),and 12 cases of vascular occlusion were found by postoperative angiography. The occurence of residual aneurysm depends upon the location,size and width of the pedicle of the aneurysm,and rupture of aneurysm during the operation.The opertors are usually not sure whether the aneurysm and the artery carrying the aneurysm have been clipped completely.Therefore,the postoperative angiography can not be omiteed. The residual aneurysm may be sympton-free after the artery being clipped,it can be found only by postoperative angiography.Hence, necessary and proper management can be carried out,and the mortality and the rate of disability after operation of the aneurysm may be decreased.