颅内复杂动脉瘤手术治疗的策略和进展

Surgical treatment strategy and progress of intracranial complex aneurysm

颅内复杂动脉瘤一直是脑血管病的治疗难点之一,无论开颅手术还是介入栓塞都存在较大困难。尽管近年来介入材料的发展突飞猛进,但仍有部分病例需要采用开颅手术方式处理。本述评从颅内复杂动脉瘤的定义、分类、特点和治疗策略展开了介绍;针对不同动脉瘤的手术原则,方式和技巧,辅助设备的应用展开了讨论。结果表明对复杂动脉瘤需要根据个体化的术前评估,制定详细和全面的手术计划,采用复合手术、血管重建等多种手术方式综合治疗,方能保证手术的安全性和获得良好效果。

Complex intracranial aneurysms have always been one of the most challenging problems in cerebrovascular diseases. They are difficult to be managed either by endovascular or extravascular approach. Although the materials for endovascular treatment have been emerging rapidly in recent years,some cases still need to be handled by craniotomy. This review introduces the definition,classification,characteristics and treatment strategies of complex intracranial aneurysms,and discusses the operation principles,methods and techniques as well the application of auxiliary equipment. The results show that establishment of a tailored and comprehensive surgical plan according to the preoperative assessment and usage of varieties of surgical methods individually,such as hybrid operation and vascular reconstruction,ensure the safety of the intrusive procedures and better outcome.