颅内-外血管搭桥加孤立术治疗大脑中动脉复杂动脉瘤

Intracranial-extracranial vascular bypass and trapping aneurysms for the treatment of complex middle cerebral artery aneurysms

目的探讨颅内-外血管搭桥加动脉瘤孤立术在大脑中动脉复杂动脉瘤治疗中的方法和效果。方法对6例大脑中动脉复杂动脉瘤患者采用颅内-外血管搭桥加动脉瘤孤立手术。术后复查脑血管造影和(或)超声评价搭桥是否通畅,并就相关临床资料进行分析。结果颞浅动脉-大脑中动脉搭桥4例中,吻合口通畅4例,运动性语言障碍加重1例。颈外动脉-大隐静脉移植-大脑中动脉搭桥2例,搭桥血管不通畅1例。随访2-17个月,恢复良好5例,生活自理1例。结论颅内-外血管搭桥加动脉瘤孤立术是治疗大脑中动脉复杂动脉瘤的可行方法。

Objective To investigate the effect and method of IC-EC bypass companied with trapping aneurysms in the treatment of complex middle cerebral artery aneurysms. Methods Six cases with complex middle cerebral artery aneurysms, in which IC-EC bypass was performed and aneurysm was trapped , were studied retrospectively. All cases were performed cerebral vascular angiography and/or ultrasound scan after surgery. Results Four cases experienced superior temporal artery-middle cerebral artery （ STA- MCA） bypass. All their anastomosis kept patent, but one worsened in aphasia post-treatment. Two cases received external carotid artery-saphenous vein-middle cerebral artery （ECA-SV-MCA） bypass, one of whom got thromboembolism of the bridge vassal. Follow-up of all cases ranged from 2 to 17months. Five of them got a good result, the other could was independent. Conclusion the treatment of intracranial -extracranial vascular bypass companied with trapping aneurysms for the complex middle cerebral artery aneurysms is an available method.