前交通动脉瘤未被夹闭的原因分析

Factors for non clipping of anterior communicating artery aneurysm

目的分析前交通动脉瘤未被夹闭的原因,探讨避免发生此种情况的措施。方法对2003年2月至2009年2月我院、外院及国外经手术夹闭的前交通动脉瘤各1例的临床资料进行回顾性分析。结果经术后全脑血管造影检查,动脉瘤完全未被夹闭。结论术前认真阅读分析血管造影资料,应完善3D-DSA或计算机体层摄影血管成像(CTA)检查,术中仔细操作,分清显微解剖结构,术中脑血管造影检查能够避免这种情况的发生。

Objective To analyge the possible factors for non clipping anterior communicating artery aneurysms disclosed by the post operative DSA examination and to discuss the measures to prevent this mistake.Methods Three patients with anterior communicating artery aneurysm were analyzed retrospectively.All of them had been performed the aneurysm clipping through pterional approach.DSA examination was done after the operation.Results The post-operative DSA examination confirmed that the aneurysms were not clipped after the craniotomy.Conclusions Careful neuroimaging study is essential for the accurate diagnosis and successful treatment of the aneurysms.3-D DSA or 3-D CTA examinations should be done before surgery.Carefully dissecting and identifying the microanatomy structures are mandatory for successful procedure.Intraoperation DSA examination can help preventing false clipping.