破裂血豆状内頚動脈前壁動脈瘤に対する急性期high-flow bypass併用動脈瘤trapping術の治療成績

• 吉川 雄一郎

  埼玉医科大学国際医療センター　脳卒中外科

• 池田 俊貴

  埼玉県立循環器・呼吸器病センター　脳神経外科

• 竹田 理々子

  埼玉医科大学国際医療センター　脳卒中外科

• 中島 弘之

  埼玉医科大学国際医療センター　脳卒中外科

• 大井川 秀聡

  帝京大学　脳神経外科

• 栗田 浩樹

  埼玉医科大学国際医療センター　脳卒中外科

書誌事項

タイトル別名

• Aneurysmal Trapping with High-flow Extracranial-intracranial Bypass for Ruptured Blood Blister-like Anterior Wall Aneurysms of the Internal Carotid Artery during the Acute Period after Subarachnoid Hemorrhage

抄録

Background: Blood blister-like aneurysms (BBAs) arising from the anterior wall of the internal carotid artery are characterized by a fragile wall, a poorly defined neck, and a high incidence of rebleeding during the acute period after subarachnoid hemorrhage (SAH). They remain as severe therapeutic challenges. The authors investigated the safety and mid-term efficacy of trapping of the aneurysm with high-flow bypass between the second portion of the middle cerebral and cervical external carotid arteries by using a radial artery graft (EC-RA-M2 bypass) for the complex lesions.<br>Methods: The medical charts of 14 consecutive patients with ruptured BBAs during the past 4 years were retrospectively reviewed. The patients' mean age was 60.0 years. The World Federation of Neurosurgical Societies grade was I or II in 7 patients and III-V in the other 7 patients. Nine patients underwent acute craniotomy within 24 hours after SAH.<br>Results: After operation, total elimination of the BBAs with good patency of the bypass was confirmed in all the patients. None of the patients had rebleeding from nor refilling of the aneurysms within a mean follow-up period of 26.5 months. Although one patient showed postoperative perforator area infarction and the other two patients had symptomatic vasospasm, good clinical outcome (Glasgow Outcome Scale: good recovery or mild disability) was observed in 12 patients (89%) at the last follow-up.<br>Conclusions: Acute surgery using aneurysmal trapping with EC-RA-M2 bypass is effective for the treatment of BBAs, with good and safe mid-term outcomes.

収録刊行物

• 脳卒中の外科

  脳卒中の外科 45 (3), 171-176, 2017

  一般社団法人 日本脳卒中の外科学会

キーワード

• subarachnoid hemorrhage
• high flow bypass
• aneurysmal trapping
• blood blister-like aneurysm

詳細情報

• CRID: 1390001204673258880
• NII論文ID: 130005712191
• DOI: 10.2335/scs.45.171
• ISSN: 18804683
• ISSN: 09145508
• Web Site: https://www.jstage.jst.go.jp/article/scs/45/3/45_171/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2017353253
• 本文言語コード: ja
• データソース種別:
  • JaLC
  • Crossref
  • CiNii Articles
  • KAKEN
• 抄録ライセンスフラグ: 使用不可