76. 前交通動脈瘤に対する定位的塞栓法

概要

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We treated for anterior communicating artery aneurysms by stereotaxic occlusion with transsphenoidal approach.<BR>[Method] Under general anesthesia the patient is inserted the catheter through the femoral artery for operative angiography. The patient's head is adjusted Wells stereotaxic instrument. A small portion to the planum sphenoidale on the stereotaxic trajectory is removed. The aneurysm was filled with iron-acrylic mixture injected through the needle with magnetic probe. 1 hour after injecting the mixture the operation finished. The patient has returned to work 7 months after the onset of SAH.<BR>[Discussion] This method has many advantages and disadvantages. It can be utilized for patients who are not candidates for conventional craniotomy because of heart or cerebrovascular disease. It is associated with short hospitalization, and no incidence of postoperative spasm. These advantages presumably result from the minimal brain and blood vessel manipulation associated stereotaxic approach. The disadvantage of the procedure depend on the aneurysm's site and size, has the risk of occlusion of the parent artery and need the extensive equipment required. We believed that this technique can be considered in the neurosurgical therapy for certain aneurysm of Acom aneurysm.
The Japanese Society on Surgery for Cerebral Strokeの論文