51. 直達手術が不可能な巨大脳動脈瘤に対する治療:-近位血管結紮術の効果-

概要

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Six patients with giant intracranial aneurysms, which measured over 2.5cm in diameter, were treated by ligation of the proximal parent artery. The location of the aneurysms were intra-cavernous in three patients, paraophthalmic in one, basilar in one, and vertebral in one. Ligation was performed on the cervical internal carotid artery in two patients, common carotid artery in two, basilar artery in one, and intracranial vertebral artery in one. Three patients were managed by combining the proximal parent artery ligation with an extracranial-intracranial arterial bypass.<BR>The effect of ligation was followed by repeated computed tomography scans with angio-graphic correlation. The aneurysm thrombosed soon after ligation, and with time, gradually organized with a reversal of the mass effect. In four patients, the aneurysm completely lost its mass effect upon the adjacent structures. In the other two patients, the aneurysm is gradually losing its mass effect.<BR>For giant aneurysms treated with ligation of the proximal parent artery, computed tomography scans are a useful method for continuing review, producing precise information concerning actual size, thrombus formation, and various pathological changes.
The Japanese Society on Surgery for Cerebral Strokeの論文