ダクロン^[○!R]テープによる微小脳動脈瘤の治療

概要

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Coagulation, coating and wrapping have been adapted as treatments for small cerebral aneurysms among imclippable aneurysm cases, and each brain surgeon decides which method to choose. A strategic method of surgical treatment is required, especially in cases of blood blister-like aneurysms found at the internal carotid artery. Although the methods of wrapping clipping and trapping plus bypass are reported, these are not standard treatments. We have adapted the wrapping-clipping method using Dacron^[○!R] tape to reinforce after coating and coagulation for cerebral small aneurysms 2-3 mm in diameter. In this method, the cerebral aneurysms as well as the parent artery are wrapped and then clipped at both ends with Dacron^[○!R] tape. We report 5 cases using this procedure: 4 SAH cases and 1 unruptured aneurysm. Three cases were considered as blood blister-like aneurysms. We used Dacron^[○!R] tape to reinforce after clipping in the SAH cases and after coating in the unruptured case. The results from the 4 cases in follow-ups averaging 4 years were good. Dacron^[○!R] tape is excellent operatively; it is reliable as reinforcement material for blood vessels and is useful for unclippable cerebral small aneurysms. In addition, it is also available for blood blister-like aneurysms because we can expect obliteration to maintain good antegrade blood flow. It is necessary to decide the strategic method of surgical treatment preoperatively.
2001-07-31