Multiple target aspiration technique for subacute stereotactic aspiration of hematomas within the basal ganglia
Multiple target aspiration technique for subacute stereotactic aspiration of hematomas within the basal ganglia
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DOI：
10.1016/s0090-3019(03)00084-3
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发表时间：
2003-07-01
影响因子：
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通讯作者：
Seifert, V
中科院分区：
文献类型：
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作者：
Marquardt, G;Wolff, R;Seifert, V
背景立体定向手术治疗深部脑内血肿作为一种微创手术已被广泛接受，但对于如何在最大限度降低患者风险的情况下抽吸足够比例的血肿仍存在争议。本文的目的是介绍一种改进的立体定向血肿抽吸术，它能显著地满足这两方面的要求。方法采用多靶点抽吸技术治疗连续收治的一系列基底节区自发性血肿患者。从抽吸程度和再出血率两个方面对该技术的结果进行评估，并与采用物理碎块或化学溶解血块的立体定向血肿抽吸术进行比较。平均误吸程度为88.8%，再出血1次(1.6%)。结论在亚急性期采用多靶点抽吸技术是一种快速、简便的深层血肿立体定向清除方法，具有成功率高、再出血风险低等优点。(C)2003 Elsevier Inc.保留所有权利。
BACKGROUNDStereotactic surgery for deep-seated intracerebral hematomas as a minimally invasive procedure has gained wide acceptance, but debate continues to be controversial concerning the issue of how to aspirate a sufficient proportion of the hematoma with minimized risk for the patient. The objective of this paper is to present a modified stereotactic aspiration technique which complies saliently with both demands.METHODSThe multiple target aspiration technique was used in a series of 64 consecutive patients with spontaneous hematomas within the basal ganglia. The results obtained with this technique were evaluated with particular regard to degree of aspiration and rate of recurrent hemorrhage and were compared with results achieved with stereotactic techniques utilizing physical fragmentation or chemical lysis of the clots.RESULTSUsing this technique, it was feasible in one single surgical procedure to aspirate more than 80% of the hematoma volume in 73.4% of the patients. Mean degree of aspiration was 88.8%, and rebleeding occurred only once (1.6%). These results compare favorably with those achieved with application of intricate stereotactic techniques.CONCLUSIONThe multiple target aspiration technique performed in the subacute stage is a rapid and simple method for stereotactic removal of deep-seated hematomas and combines a high success rate with very low risk of recurrent hemorrhage. (C) 2003 Elsevier Inc. All rights reserved.