[(12)Revascularisation and aneurysms of the posterior circulation].
[(12)Revascularisation and aneurysms of the posterior circulation].
复制标题
[(12)后循环血运重建和动脉瘤]。
DOI：
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发表时间：
2014
期刊：
影响因子：
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通讯作者：
Y. Yonekawa
中科院分区：
文献类型：
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作者：
Y. Yonekawa
本文是“神经外科手术的历史背景与个人观点”系列的最后一篇文章，即第十二个专题。“在这篇文章中，血运重建和后循环动脉瘤是主题。作为一个典型的后循环EC-IC旁路的例子，基底动脉狭窄的情况下。STA-SCA旁路的良好通畅性导致狭窄闭塞，尽管最初显示临床改善，但几个月后表现为严重的脑桥梗死。对这种恶性转化的考虑进行了讨论，可能的预防方法。其他血运重建方法，包括小脑上经小脑幕入路（SCTTA），即OA-SCA或OA-PCA旁路在坐位，并讨论其优点和缺点。至于后循环动脉瘤，SEAC的作用和它的优势，治疗基底动脉分叉部动脉瘤的介绍和讨论。SCTTA和SAHE入路是治疗其他PCA动脉瘤的特殊入路，并强调了后者在P2-P3交界处动脉瘤获得载瘤动脉P2的优势。还讨论了坐位血运重建或动脉瘤手术的优点，手术区域的清洁情况下，过早破裂或夹闭程序，并通过布什的下颅神经。
This is the last article, namely, the twelfth topic, in the series "personal view and historical backgrounds of operative neurosurgery." In this article, revascularisation and aneurysms of the posterior circulation are thematized. As an example for classic posterior circulation EC-IC bypass, a case of basilar stenosis is presented. The stenosis turned out to occlusion by good patency of the STA-SCA bypass, and although it initially showed clinical improvement, it manifested as severe pontine infarction several months later. Considerations on such malignant conversion are discussed together with probable prevention methods. Other revascularisation methods involving the supracerebellar transtentorial approach(SCTTA), namely, OA-SCA or OA-PCA bypass in the sitting position, are presented and their advantages and disadvantages are discussed. As for posterior circulation aneurysms, the role of SEAC and its advantages for treating basilar bifurcation aneurysms are presented and discussed. SCTTA and SAHE approach are presented as special approaches for other PCA aneurysms, and their advantages of getting the parent artery P2 for P2-P3 junction aneurysm in the latter was emphasized. The advantage of a sitting position for revascularisation or aneurysm surgeries, cleanliness of the operative field in cases of premature rupture or clipping procedure, and through the bush of lower cranial nerves are also discussed.