Successful Staged Obliteration of Three Unruptured Cerebral Aneurysms by Clipping, Coiling, and Proximal Occlusion: Report of a Case

對於腦內多個或無法手術的動脈瘤之治療，經血管的技術提供手術之輔助性或另一種治療工具。近端動脈阻塞，有時合併顱內外血管繞道手術，常被用來治療無法手術的動脈瘤。本文報導一位七十歲女性因患有一巨大且無法手術的內頸動脈瘤，而以左側海綿靜脈竇症候群表現，此外仍另有兩個動脈瘤被發現，她接受動脈瘤手術夾扼(clipping)、白金線圈(GDCs)栓塞,及使用氣球(GVBs)作近端動脈阻塞的合併療法。五個月後血管攝影檢查顯示左側的內頸動脈瘤完全被栓塞，左側大腦循環獲得很好的重建，右側的內頸動脈瘤完全被線圈栓塞，以及左側中腦動脈瘤成功的被手術夾除。此外，左側海綿靜脈竇症候群之症狀在治療後三個月完全消失。作者借此病例分析三個不同位置的動脈瘤，依其不同的特性，選擇不同的治療方法，並針對這些治療方式的理論基礎，適用時機做適當的說明與討論。

關鍵字

無資料

並列摘要

Endovascular techniques offer a mode of therapy alternative or adjuvant to surgery in treatment of multiple or inoperable cerebral aneurysms. Proximal arterial occlusion, with or without extracranial-to-intracranial (EC-IC) bypass, is frequently performed for inoperable cerebral aneurysms. The authors report hereby a 70-yearold woman presenting with the left cavernous sinus syndrome because of a giant inoperable internal carotid aneurysm. In addition, two other aneurysms were identified. The patient underwent staged obliteration of the three aneurysms by clipping, Guglielmi detachable coils (GDCs) embolization, and proximal internal carotid artery occlusion with golden valve balloons (GVBs). At 5-month follow-up, the cerebral angiogram showed that the left ICA aneurysm was completely obliterated, the right ICA aneurysm was totally occluded by GDCs, and the left MCA aneurysm was successfully clipped. In addition, the collateral circulation of the left hemisphere had been well reestablished. Symptoms and signs of the left cavernous sinus syndrome subsided about three months after the treatment. Triple aneurysms can be managed successfully with a combination of different therapies.

並列關鍵字

Endovascular techniques ； Multiple intracranial aneurysm

國際替代計量

Successful Staged Obliteration of Three Unruptured Cerebral Aneurysms by Clipping, Coiling, and Proximal Occlusion: Report of a Case

全文下載

主題瀏覽