50. 内頸動脈瘤の再手術:-クリッピングおよびコーティソグ併用術後再発に対して-
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概要
- 論文の詳細を見る
The patient, a 42-year-old male, suffered from subarachnoid hemorrhage in June 1974. A broad based saccular aneurysm on the C<SUB>2</SUB> portion which projected superolaterally was shown on the left carotid angiogram (CAG). In the 27th of June 1974, neck clipping and coating with Biobond<SUP>®</SUP> of the aneurysm were performed through the left pterional approach. Postoperatively he suffered from right hemiparesis and aphasia, but these symptoms recovered in 10 days after operation. Repeated CAG was done 7 times during about 3 years postoperatively. On these examinations it was found out that rest neck coated with Biobond<SUP>®</SUP> had been expanding into the saccular aneurysm gradually. In the 18th of July 1976, the reoperation was performed through the left pterional approach again. Operative findings as follows: the aneurysm and the parent artery were covered with the elastic hard"Scar". Beneath the"Scar", the Biobond<SUP>®</SUP> film was found. The"Scar"and the Biobond<SUP>®</SUP> film were sharply dissected with scissors. The Biobond<SUP>®</SUP> film attached to the aneurysm is easy to dissect, while the film attached to the metal clip is difficult. The recurrent aneurysm was covered with the Biobond<SUP>®</SUP> film partially, which was stripped out from the parent artery. The clip, applied at the first operation, was removed. Then the encircle type clip was used to the aneurysm. Tissue reaction, nature and adhesive power of the Biobond<SUP>®</SUP> film were discussed about based on operative findings. It is pointed out that prevention of recurrence of the aneurysm is difficult by means of coating with Biobond<SUP>®</SUP>. We concluded that wrapping and coating combined method must be choiced to prevent recurrence of the aneurysm.
- The Japanese Society on Surgery for Cerebral Strokeの論文