双腔球囊导管在颅内大型、巨大型动脉瘤夹闭术中的临床应用

Applications of cristal balloon peripherique in large or giant intracranial aneurysms clipping surgery

目的讨论颅内大型、巨大型动脉瘤夹闭术中双腔球囊导管(CBP)应用的若干问题。方法应用CBP辅助夹闭颅内大型、巨大型动脉瘤5例,动脉瘤最大直径20mm1例,其余25～35mm。术前CBP预置在动脉瘤近端,术中显露部分瘤体后充盈球囊阻断血供,经内套管逆向抽吸导管远端的血液,瘤内压下降后夹闭瘤颈。结果5例均成功夹闭瘤颈。1例大脑中动脉瘤术后对侧肢体轻偏瘫,对症治疗后基本恢复,其余术后均无神经功能障碍。1例术后一年复查DSA,动脉瘤未见显影。结论双腔球囊导管(CBP)应用于颅内大型、巨大型动脉瘤夹闭术中,既可有效阻断载瘤动脉血流,又可通过逆向抽吸降低瘤内压,有利于防止瘤体破裂、安全夹闭瘤颈。

Objective To discuss the application of cristal balloon peripherique （CBP） in clipping of large or giant intracranial aneurysms. Methods 5 large or giant intracranial aneurysms were clipped assisted with CBP. The diameter of the aneurysms is 20 - 35 mm. Before surgery, the CBP was inserted into internal carotid artery approaching the aneurysm. When the aneurysm was partly exposed, the balloon was engorged to obstruct bloodstream running into the aneurysm. Then, it was clipped when the aneurysm was withered by withdrawing the blood in the aneurysm with CBP. Results 5 aneurysms were clipped. All have good results except contralateral hemiplegia in one patient with middle cerebral artery aneurysm. Follow-up angiograms demonstrate complete obliteration of the aneurysm one year after clipping in one patient. Conclusions It can obstruct bloodstream running into the aneurysm and decrease intra-aneurysm pressure by reversed sucking that CBP were applied to clip large or giant intracranial aneurysms, and provide an utility method for large or giant intracranial aneurysms.