55. 頭蓋内内頸動脈巨大動脈瘤の非直達手術とCTによる追跡

概要

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Thirty five patients with giant aneurysms of intracranial internal carotid artery were experienced from 1961 to 1983. Four out of 35 were given no treatment, eight were operated directly and the remaining 23 were treated by indirect surgery; carotid ligation was performed in 14 cases and carotid ligation with STA-MCA anatomosis in nine.<BR>At follow-up, 17 out of 23 patients (73.9%) operated indirectly were living useful lives; ten of these cases were treated by carotid ligation, seven by carotid ligation with STA-MCA anastomosis. Eighteen out of 23 cases were examined by CT scan to investigate the fate of the giant aneurysm following carotid ligation. Follow-up periods were from one month to 12 years.<BR>CT findings which prove the effectiveness of indirect surgical treatment were observed in 17 cases (94.6%). However, complications after carotid ligation cannot be neglected; four out of 14 patients performed carotid ligation only were lost. Therefore, combined therapy consisting of neck internal carotid ligation and STA-MCA anastomosis is recommended to prevent complications due to carotid ligation.<BR>Sequential CT scans are useful for observation of the fate of the giant aneurysm after carotid ligation and for evaluation of the prognosis of patients.
The Japanese Society on Surgery for Cerebral Strokeの論文