摘要
目的探讨吲哚菁绿术中荧光血管造影在颅内动脉瘤手术中的应用，减少术后并发症，提高手术的安全性。方法回顾性总结18例25个颅内动脉瘤。术中动脉瘤夹闭前后均行吲哚菁绿荧光血管造影检查，根据造影结果，必要时调整动脉瘤夹。术后复查CT判断有无缺血梗死，复查DSA或CTA判断动脉瘤夹闭情况。结果术中荧光血管造影发现动脉瘤残颈1例，载瘤动脉狭窄2例，远端分支狭窄1例，穿通支闭塞1例，均根据造影结果及时调整动脉瘤夹。术后复查CT无缺血性梗死出现，1例术后因动脉瘤夹闭不全出血，二次手术清除血肿，并调整动脉瘤夹。16例复查DSA或CTA见动脉瘤夹闭完全，架桥血管通畅。结论吲哚菁绿术中荧光血管造影对于判断载瘤动脉是否狭窄、动脉瘤是否有残颈、动脉瘤远端血管和穿支血管是否狭窄或闭塞、架桥血管是否通畅有重要的参考价值，可有效的减少术后并发症，提高手术的安全性，是一种方便快捷、安全有效的术中血管造影技术。
Objective To study the application of intraoperative indocyanine green videoangiography in the surgical treatment of intracranial aneurysms to improve the efficacy and safety. Methods We retrospectively analyzed 18 patients harboring 25 intracranial aneurysms. All the patients routinely underwent indocyanine green videoangiography before and after the clipping of aneurysms. According to the result of fluorescent angiography, the clip was adjusted if necessary. Postoperatively, CT was performed to identify whether there was infarction and DSA or CTA were performed to confirm the complete aneurysm obliteration. Results During the operations, aneuryismal neck remnant was found in one case, parent arteries stenosis was found in two, distal branch stenosis was found in one, and perforating artery occlusion was found in one. Immediately after these findings, the clips were replaced until satisfactory blood flow was restored. Postoperatively, there was no ischemic infarction. Cerebral hematoma due to unsatisfactory clipping of the aneurysm was found in one patient and the second operation was performed to evacuate the bleeding and readjust the clip. Complete clipping and parent bypass vessels were comfirmed by DSA or CTA exams in 16 patients. Conclusion Intraoperative indocyanine green videoangiography is useful to judge whether the aneurysm is completely obliterated, whether the parent and distal artery is stenosis, and whether the perforating artery is occluded. This technique is convenient, fast, and safe. It will play an important role in improving the clinical outcomes of intracranial aneurysm.
出处
《中华神经外科杂志》
CSCD
北大核心
2008年第8期570-572,共3页
Chinese Journal of Neurosurgery
