颌内动脉搭桥治疗颅内复杂动脉瘤

Internal maxillary artery bypass for intracranial complex aneurysms

目的评价颌内动脉搭桥治疗颅内复杂动脉瘤的临床中远期治疗效果。方法回顾性分析91例颅内复杂动脉瘤行颌内动脉搭桥病人的临床资料,使用mRS评分评价病人中远期预后。结果出院时mRS评分0~2分67例(73.6%),3~5分23例(25.3%),死亡1例。83例随访31~136个月,平均(82.0±25.0)个月,mRS评分0~2分67例(80.7%),3~5分6例(7.2%);死亡10例(12.0%),其中死于肺部感染5例,大面积脑梗死2例,颅内出血1例,胰腺癌1例,对侧动脉瘤破裂1例。结论颌内动脉搭桥是治疗颅内复杂动脉瘤的有效方式之一,其术式选择可忽略动脉瘤的个体化差异。

Objective To evaluate the clinical medium and long-term effect of intracranial complex aneurysm(ICCA)treated by internal maxillary artery(IMA)bypass.Methods Clinical data of 91 patients with ICCA undergoing IMA bypass were analyzed retrospectively.The mRS score was used to evaluate the medium and long-term prognosis of the patients.Results MRS scores were 0 to 2 points in 67 patients(73.6%)and 3 to 5 points in 23 patients(25.3%)on discharge,and 1 patient died.Eighty-three patients were followed up for the mean time of 82.0±25.0 months,ranged from 31 to 136 months.The mRS scores were 0 to 2 points in 67 patients(80.7%)and 3 to 5 points in 6(7.2%).Ten patients(12.0%)died,including death of pulmonary infection in 5,massive cerebral infarction in 2,intracranial hemorrhage in 1,pancreatic cancer in 1 and contralateral aneurysm rupture in 1.Conclusion IMA bypass is one of the effective methods for the treatment of ICCA,and the individual differences of aneurysms can be ignored.