|
|
|
| Clinical Analysis of Anterior Circulation Aneurysm Clipping Assisted by Fluorescein Angiography in the Treatment of Anterior Circulation Aneurysm |
| ZENG Qun, JIANG Hui, XU Fan, et al |
| Department of Neurosurgery, Xiangtan Central Hospital, Hunan Province 411100,China |
|
|
|
|
Abstract 【Objective】To investigate the value of indocyanine green angiography in the treatment of anterior circulation aneurysms by craniotomy. 【Methods】From March 2017 to March 2019, 90 cases of anterior circulation aneurysms were clipped by fluorescence-assisted microsurgery in neurosurgery department of Xiangtan Central Hospital. The clipping effect of aneurysms was evaluated by head CTA or DSA within 3 days after operation, and the prognosis was evaluated by GOS score three months after operation. 【Results】Six patients had parent artery stenosis after the first clipping. After changing the appropriate aneurysm clip or adjusting the position of the aneurysm clip, fluorescence angiography showed that the parent artery was unobstructed; 4 patients found residual aneurysm neck, 2 of these 4 patients added an aneurysm clip, and the other 2 timely adjusted the position of the aneurysm clip, and finally completely clipped the aneurysm. In 9 patients, the perforating vessels were mistakenly clipped. After angiography, the location of the aneurysm clip was adjusted to avoid the false clipping. The results of postoperative reexamination showed that there were no parent artery stenosis, residual tumor neck and perforating vessel injury in 90 patients. After 3 months of follow-up, all patients were evaluated by gos score. The GOS score was 4 points and 5 points in 68 cases, that is, mild disability but can live independently or return to normal life belongs to good recovery. The excellent and good rate of patients in this study was 75.6% (68/90). 【Conclusion】Indocyanine green fluorescence angiography assisted anterior circulation aneurysm clipping can effectively reduce the incidence of complications such as parent artery stenosis, residual aneurysm neck, perforating vessel injury, etc., and can improve the quality of life of patients, which has high clinical application value.
|
|
Received: 09 September 2019
|
|
|
|
|
|
[1] 刘海巍,陶胜忠,陈辉,等. 不同入路夹闭前循环动脉瘤的临床疗效分析[J].重庆医学,2017,46(28):3928-3931.
[2] 杨纪明,王杰,张波,等. 开颅夹闭前循环动脉瘤43例临床分析[J].中国实用神经疾病杂志,2017,20(23):90-95.
[3] 郭小川. 吲哚菁绿造影在颅内动脉瘤夹闭术中应用的研究进展[J].内蒙古医学杂志,2019,51(4):421-425.
[4] 张国锋,唐尤佳,高翔,等. 吲哚菁绿荧光血管造影在颅内动脉瘤手术中的应用[J].新乡医学院报,2019,36(3):234-238.
[5] 江辉,杨佳宁,曾群. 开颅夹闭术和血管内栓塞术治疗前交通动脉瘤的疗效分析[J].中国现代医学杂志,2017,27(1):129-132.
[6] 李爱国,刘之彝,龙晓东,等. 颅内动脉瘤介入栓塞术和颅内夹闭术治疗高分级动脉瘤性蛛网膜下腔出血的临床疗效观察[J].临床外科杂志,2018,26(7):497-501.
[7] 姬忠庆,王瑾. 经颅多普勒超声及微血管多勒普超声在检测动脉瘤破裂后血管痉挛中的应用[J].中国医药导报,2018,15(23):100-102.
[8] 张洁,艾芬. 经眶上外侧与经翼点入路治疗破裂前循环动脉瘤急性期的临床疗效比较[J].医学临床研究,2018 Vol. 35 (4): 742-744.
[9] Feletti A,Wang X,Tanaka R,et al.Dual-image videoan-giography during intracranial microvascular surgery[J].World Neurosurgery,2017,99:572-579.
[10] Riva M,Aminhanjani S,Giussani C,et al.Indocyanine green videoangiography in aneurysm surgery:systematic review and Meta-Analysis[J].Neurosurgery,2017,83(2):166-180. |
|
|
|
2020, Vol. 37 
