显微剪辑闭塞大脑中动脉瘤术中流量评估
Summary
利用超声波流量探头，以评估动脉瘤夹安置前，后动脉血流脑动脉瘤的手术闭塞的描述。
Abstract
脑动脉瘤是本地化段的颅内血管的异常扩大或气球。手术夹闭是一个重要的治疗动脉瘤的尝试，排除血液流入动脉瘤的血管段，同时保持在一个正常的方式中的血流量。剪辑放置不当，可能会导致与随后的动脉瘤破裂出血或远端动脉闭塞导致脑梗塞的部分或全部的潜力剩余瘤。在这里，我们描述了使用一个超声波流量探头，提供前后显微剪辑放置在一个大脑中动脉瘤的基础动脉血流的定量评价。此信息有助于确保足够的动脉瘤重建，维护正常的远端血流。
Protocol
脑动脉瘤是本地化段的颅内血管的异常扩大或气球。这些病变通常发生在动脉壁逐渐弱化的结果母管分支点。后动脉瘤破裂导致蛛网膜下腔出血，脑血管瘤是最常见的检测。这颅内出血的形式进行的第一个月内的死亡率45％的风险破裂后，幸存者往往遇到严重的永久性神经损伤1。最近，由于越来越多地使用先进的成像方式，如MRI和CT扫描，脑血管瘤是经常遇到的包括手术夹闭和弹簧圈栓塞…
References
- Johnston, S. C., Selvin, S., Gress, D. R. The burden, trends, and demographics of mortality from subarachnoid hemorrhage. Neurology. 50, 1413-1418 (1998).
- Alexander, T. D., Macdonald, R. L., Weir, B., Kowalczuk, A. Intraoperative angiography in cerebral aneurysm surgery: a prospective study of 100 craniotomies. Neurosurgery. 39, 10-17 (1996).
- Tang, G., Cawley, C. M., Dion, J. E., Barrow, D. L. Intraoperative angiography during aneurysm surgery: a prospective evaluation of efficacy. Journal of neurosurgery. 96, 993-999 (2002).
- Katz, J. M. Is routine intraoperative angiography in the surgical treatment of cerebral aneurysms justified? A consecutive series of 147 aneurysms. Neurosurgery. 58, 719-727 (2006).
- Charbel, F. T., Hoffman, W. E., Misra, M., Ostergren, L. Ultrasonic perivascular flow probe: technique and application in neurosurgery. Neurological research. 20, 439-442 (1998).
- Fagundes-Pereyra, W. J., Hoffman, W. E., Misra, M., Charbel, F. T. Clip readjustment in aneurysm surgery after flow evaluation using the ultrasonic perivascular probe: case report. Arquivos de neuro-psiquiatria 63. , 339-344 (2005).
- Amin-Hanjani, S., Meglio, G., Gatto, R., Bauer, A., Charbel, F. T. The utility of intraoperative blood flow measurement during aneurysm surgery using an ultrasonic perivascular flow probe. Neurosurgery. 62, 1346-1353 (2008).
- Amin-Hanjani, S., Charbel, F. T. Flow-assisted surgical technique in cerebrovascular surgery. Surgical neurology. 68, S4-11 (2007).
Tags
Microsurgical ClipMiddle Cerebral AneurysmIntraoperative Flow AssessmentSurgical ClippingAneurysm TreatmentClip PlacementResidual AneurysmAneurysm RuptureDistal Arteries OcclusionCerebral InfarctionUltrasonic Flow ProbeQuantitative EvaluationArterial FlowMicrosurgical Clip PlacementMiddle Cerebral Artery AneurysmAneurysm ReconstructionNormal Distal Blood Flow
Cite This Article
Carter, B. S., Farrell, C., Owen, C. Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment. J. Vis. Exp. (31), e1294, doi:10.3791/1294 (2009).