动脉瘤切除加端-端吻合治疗颅内梭形动脉瘤2例报道并文献复习

Excision and end-to-end reanastomosis for fusiform intracranial aneurysms(report of two cases and literature review)

目的探讨颅内梭形动脉瘤的颅内-颅内血管搭桥术式。方法回顾性分析2例颅内梭形动脉瘤患者的临床资料,并对相关文献进行复习。结果2例颅内梭形动脉瘤患者行动脉瘤切除加端-端吻合术,疗效满意。结合文献复习,颅内梭形动脉瘤的颅内-颅内血管搭桥术多采用再植术、原位搭桥和再吻合术等治疗。结论动脉瘤切除加载瘤动脉瘤的端-端再吻合术是有效治疗颅内梭形动脉瘤的血流重建技术,避免颅外供体血管的获取。颅内梭形动脉瘤的颅内-颅内搭桥术宜个体化,搭桥术式取决于动脉瘤的部位、载瘤动脉和邻近有无供体血管等因素。

Objective To explore intracranial-intracranial bypasses for fusiform intracranial aneurysms. Methods The clinical data of two patients with fusiform intracranial aneurysms were analyzed retrospectively and the literature were reviewed. Results The aneurysms were treated by surgical resection and end-to-end reanastomosis and the results were satisfactory. As the literature review demonstrated, fusiform intracranial aneurysms using intracranial-intracranial bypasses were usually performed by reimplantation, in situ bypass, and reanastomosis. Conclusions Aneurysm excision and end-to-end reanastomosis is an efficient revascularization technique for fusiform aneurysms that have 1 afferent and 1 efferent artery, obviating the need for harvesting extracranial donor arteries. Bypass strategies should be designed according to aneurysm location, the parent artery and in situ donor arteries.