Quantitative angiographic haemodynamic evaluation of bypasses for complex aneurysms: a preliminary study  

作　　者：Junlin Lu Chao Xue Xulin Hu Yuanli Zhao Dong Zhang Xiaolin Chen Ji Zong Zhao 

机构地区：[1]Neurosurgery,Beijing Tiantan Hospital,Beijing,People's Republic of China [2]Department of Industrial Engineering,Tsinghua University,Beijing,People's Republic of China [3]Chengdu Institute of Organic Chemistry,Chinese Academy of Sciences,Chengdu,People's Republic of China [4]University of the Chinese Academy of Sciences,Beijing,People's Republic of China [5]China National Clinical Research Center for Neurological Diseases,Beijing,People's Republic of China [6]Stroke Center,Beijing Institute for Brain Disorders,Beijing,People's Republic of China [7]Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease,Beijing,People's Republic of China [8]Beijing Translational Engineering Enter for 3D Printer in Clinical Neuroscience,Beijing,People's Republic of China

出　　处：《Stroke & Vascular Neurology》2022年第1期54-61,共8页卒中与血管神经病学（英文）

基　　金：supported by the National Key Technology Research and Development Program of the Ministry of Science and Technology of China(2015BAI12B04);Beijing Science and Technology Supporting Plan(D16110000381605);Beijing Municipal Administration of Hospitals’Mission Plan(SML20150501);Beijing Municipal Administration of Hospitals Incubating Program(PX2016034);National Natural Science Foundation of China(81571110,81771234).

摘　　要：Objective Open microsurgery,often with bypass techniques,is indispensable for complex aneurysms.To date,it remains unknown whether arterial anatomy or quantitative blood flow measurements can predict insufficient flow-related stroke(IRS).The present study aimed to evaluate the risk factors for IRS in patients treated with open microsurgery with bypass procedures for complex internal carotid artery aneurysms.Methods Patients with complex aneurysms undergoing bypass surgery were retrospectively reviewed.The recipient/donor flow index(RDFI)was preoperatively evaluated using colour-coding angiography.RDFI was defined as the ratio of the cerebral blood volume of the recipient and donor arteries.The sizes of the recipient and donor arteries were measured.The recipient/donor diameter index(RDDI)was then calculated.IRS was defined as the presence of new postoperative neurological deficits and infarction on postoperative CT scans.We assessed the association between RDFI and other variables and the IRS.Results Twenty patients(38±12 years)were analysed.IRS was observed in 12 patients(60%).Patients with postoperative IRS had a higher RDFI than those without postoperative IRS(p<0.001).RDDI was not significantly different between patients with and without IRS(p=0.905).Patients with RDFI>2.3 were more likely to develop IRS(p<0.001).Conclusion Quantitative digital subtraction angiography enables preoperative evaluation of cerebral blood volume.RDFI>2.3,rather than RDDI,was significantly associated with postoperative IRS.This preoperative evaluation allows appropriate decisions regarding the treatment strategy for preventing postoperative IRS.

关 键 词：BYPASS ANATOMY ANEURYSM 

分 类 号：R732.21[医药卫生—肿瘤] R331[医药卫生—临床医学]