动脉瘤性蛛网膜下腔出血具有较高的死亡率（40％～50％）,无论是否破裂,及时的识别与恰当的处理都是十分必要的.随着血管内介入治疗的不断进步,绝大多数颅内动脉瘤已采用该技术进行干预.然而,对于某些动脉瘤,基于他们的位置和（或）形态...动脉瘤性蛛网膜下腔出血具有较高的死亡率（40％～50％）,无论是否破裂,及时的识别与恰当的处理都是十分必要的.随着血管内介入治疗的不断进步,绝大多数颅内动脉瘤已采用该技术进行干预.然而,对于某些动脉瘤,基于他们的位置和（或）形态,仍需行动脉瘤夹闭术,并作为治疗的首选.短暂的心脏停搏可以降低术中动脉瘤张力,减少术中破裂,有助于成功夹闭动脉瘤.腺苷可诱发心脏骤停,在短时间内引起控制性低血压,是一种可行的药物选择.本文作者来自美国威尔康奈尔医学院神经外科教授、休斯顿卫理神经研究所副主任及神经外科主任GAVIN W. BRITZ教授,对治疗各种复杂脑动脉瘤具有丰富的经验,他在文中介绍了颅内动脉瘤手术过程中腺苷的使用,并描述了其动力学特征、适应证、禁忌证、并发症及未来的发展方向等.展开更多
Cerebral aneurysms have a high mortality rate when ruptured.Endovascular techniques have improved substantially in treating this pathology.However,surgical clip ligation remains the preferred option for some aneurysms...Cerebral aneurysms have a high mortality rate when ruptured.Endovascular techniques have improved substantially in treating this pathology.However,surgical clip ligation remains the preferred option for some aneurysms.Various techniques are used intraoperatively to assist the surgeon in dissecting the aneurysmal dome free of surrounding tissue and placing a clip around the neck safely and effectively so that no nearby perforating vessels are affected and no residual remains.These techniques include temporary clip ligation,endovascular balloon occlusion and cardiac standstill.Adenosine use is one viable option for induced cardiac arrest leading to a short period of controlled hypotension.Its predictable course of action,rapid onset and offset and rare incidence of adverse side effects make it an attractive agent in this regard.Below,we provide an introduction to adenosine use,describing its pharmacokinetic properties,indications,contraindications,complications and future directions.展开更多
文摘动脉瘤性蛛网膜下腔出血具有较高的死亡率（40％～50％）,无论是否破裂,及时的识别与恰当的处理都是十分必要的.随着血管内介入治疗的不断进步,绝大多数颅内动脉瘤已采用该技术进行干预.然而,对于某些动脉瘤,基于他们的位置和（或）形态,仍需行动脉瘤夹闭术,并作为治疗的首选.短暂的心脏停搏可以降低术中动脉瘤张力,减少术中破裂,有助于成功夹闭动脉瘤.腺苷可诱发心脏骤停,在短时间内引起控制性低血压,是一种可行的药物选择.本文作者来自美国威尔康奈尔医学院神经外科教授、休斯顿卫理神经研究所副主任及神经外科主任GAVIN W. BRITZ教授,对治疗各种复杂脑动脉瘤具有丰富的经验,他在文中介绍了颅内动脉瘤手术过程中腺苷的使用,并描述了其动力学特征、适应证、禁忌证、并发症及未来的发展方向等.
文摘Cerebral aneurysms have a high mortality rate when ruptured.Endovascular techniques have improved substantially in treating this pathology.However,surgical clip ligation remains the preferred option for some aneurysms.Various techniques are used intraoperatively to assist the surgeon in dissecting the aneurysmal dome free of surrounding tissue and placing a clip around the neck safely and effectively so that no nearby perforating vessels are affected and no residual remains.These techniques include temporary clip ligation,endovascular balloon occlusion and cardiac standstill.Adenosine use is one viable option for induced cardiac arrest leading to a short period of controlled hypotension.Its predictable course of action,rapid onset and offset and rare incidence of adverse side effects make it an attractive agent in this regard.Below,we provide an introduction to adenosine use,describing its pharmacokinetic properties,indications,contraindications,complications and future directions.
