经非优势A1侧眶上锁孔入路夹闭前交通动脉动脉瘤  

Clipping of anterior communicating artery aneurysms via supraorbital keyhole approach from the side of non-dominant A1

作　　者：伦鹏[1] 胥建[1] 赵彦[1] 窦以河[1] 

机构地区：[1]青岛大学附属医院神经外科,266071

出　　处：《国际脑血管病杂志》2017年第5期420-424,共5页International Journal of Cerebrovascular Diseases

摘　　要：目的探讨自非优势侧眶上锁孔入路夹闭前交通动脉动脉瘤（anterior communicating artery aneurysm，ACoAA）的手术方法、经验和技巧。方法回顾性分析根据前交通动脉和双侧A2段形成的A2开放平面朝向选择经非优势侧眶上锁孔入路夹闭的ACoAA病例资料，对手术方法和经验进行分析，总结该方法的适应证和优缺点。结果12例患者的ACoAA均经非优势侧眶上锁孔入路完全夹闭，优势A1段动脉均显露良好。术后随访4～29个月均未发现动脉瘤复发或再破裂，格拉斯哥转归量表评分5分11例，4分1例。结论ACoAA可经非优势A1侧眶上锁孔入路完全夹闭，是一种能获得良好疗效的微创手术方式。Objective To investigate the surgical method, experience, and skills in clipping anterior communicating artery aneurysm （ACoAA） via supraorbital keyhole approach. Methods The ACoAA case data of selectively clipping via non-dominant supraorbital keyhole approach according to the A2 open plane formed by the anterior communicating artery and the bilateral A2 segments were analyzed retrospectively. The surgical method and experience were analyzed. The indications and advantages and disadvantages of this method were summarized. Results ACoAA in 12 patients were completely clipped via supraorbital keyhole approach from the side of non-dominant A1, and the dominant A1 segment arteries were well exposed. The patients were followed up for 4-29 months after procedure. No recurrence or rupture of the aneurysms was found. The Glasgow Outcome Scale score was 5 in 11 patients and 4 in 1 patient. Conclusions ACoAA can be completely clipped via supraorbital keyhole approach from the side of non-dominant A1. It is a minimally invasive surgical approach with good efficacy.

关 键 词：颅内动脉瘤 脑血管造影术 体层摄影术 X线计算机 成像 三维 神经外科手术 治 疗结果 

分 类 号：R651.12[医药卫生—外科学]