颅内前循环巨大动脉瘤的显微手术技巧

Microsurgical strategy of giant intracranial aneurysms of the anterior circulation

目的探讨颅内前循环巨大动脉瘤的显微手术技巧。方法回顾性分析西京医院神经外科2013-09~2016-09显微手术治疗的14例颅内前循环巨大动脉瘤患者的临床资料,所有患者均为栓塞高风险病例,均行翼点入路,术中常规吲哚菁绿荧光造影监测手术效果,术后长期随访观察患者预后。结果 14例前循环巨大动脉瘤患者均经翼点入路成功夹闭动脉瘤,格拉斯哥预后评分(GOS)良好12例(85.7%)、差1例(7.1%)、死亡1例(7.1%)。结论显微手术可有效夹闭颅内前循环巨大动脉瘤,对于特殊类型动脉瘤,需采用相应的特殊处理措施。

Objective To investigate the microsurgical technique of giant intracranial aneurysms of the anterior circulation. Methods The clinical data of 14 patients with giant anterior circulation aneurysms in the Department of Neurosurgery in Xijing Hospital were analyzed retrospectively from September 2013 to September 2016. All the patients showed a high risk to receive embolization. They were operated through the pterional approach and monitored routinely with intra-operative indocyanine green angiography. The prognosis was observed after surgery for a long-term follow-up. Results All 14 patients were successfully clipped through the pterional approach. Of the 14 patients,12（ 85. 7%） had good GOS score,1（ 7. 1%） had poor GOS score,and 1（ 7. 1%） died. Conclusion Patients with giant intracranial aneurysms of the anterior circulation can be effectively treated with microsurgery,and the special types of aneurysms should be treated by special methods.