荧光造影辅助眶外侧锁孔入路夹闭颈内动脉分叉部动脉瘤的疗效分析

Efficacy of fluorescein angiography assisted occlusion via lateral-orbital keyhole approach in internal carotid bifurcation aneurysms

目的:探讨荧光造影辅助眶外侧锁孔入路夹闭颈内动脉分叉部动脉瘤的疗效及临床经验。方法:回顾性分析徐州医科大学附属连云港医院神经外科自2016年1月至2020年12月收治的16例颈内动脉分叉部动脉瘤患者临床资料,所有患者均采用荧光造影辅助经眶外侧锁孔入路手术治疗。所有患者术后1、3、6个月时定期行影像学随访,术后6个月时通过格拉斯哥预后量表(GOS)评分评价治疗效果。结果:16例动脉瘤均一期手术夹闭。术中荧光造影及FLOW 800技术显示动脉瘤夹闭完全、无残留,载瘤动脉、穿支动脉血流通畅。术后6个月时14例患者恢复良好(GOS评分5分),2例患者轻残(GOS评分4分)。结论:荧光造影辅助眶外侧锁孔入路夹闭颈内动脉分叉部动脉瘤安全有效。

Objective To investigate the efficacy and clinical experiences of fluorescein angiography assisted occlusion via lateral-orbital keyhole approach in internal carotid bifurcation aneurysms.Methods The clinical data of 16 patients with internal carotid artery bifurcation aneurysms admitted to our hospital from January 2016 to December 2020 were retrospectively analyzed.All patients accepted fluorescein angiography assisted occlusion via lateral-orbital keyhole approach.The patients were followed up at one,3,and 6 months after surgery by medical imaging.The therapeutic efficacy of these patients was assessed by Glasgow outcome scale(GOS).Results All aneurysms in these 16 patients were clipped at one-stage operation.Intraoperative fluorescein angiography and FLOW 800 showed that the aneurysms were completely clipped without residual,and the blood flow of the parent artery and perforating arteries was unobstructed.Six months after surgery,14 patients recovered well(GOS scores of 5),and 3 developed limb hemiplegia(GOS scores of 4).Conclusion Intraoperative fluorescein angiography assisted occlusion via lateral-orbital keyhole approach is safe and effective in internal carotid bifurcation aneurysms.