Repair of a tear at the base of a blister-like aneurysm with suturing and an encircling clip: Technical note
Repair of a tear at the base of a blister-like aneurysm with suturing and an encircling clip: Technical note
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DOI：
10.1097/00006123-200201000-00037
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发表时间：
2002-01-01
期刊：
影响因子：
4.8
通讯作者：
Nose, T
中科院分区：
文献类型：
--
作者：
Yanaka, K;Meguro, K;Nose, T
目的：如果动脉瘤撕裂在载瘤血管的颈部，就会在载瘤血管上造成很大的缺陷。作者介绍了一种修复颈内动脉前壁动脉瘤显微手术夹闭过程中遇到的水泡状动脉瘤底部撕裂的技术。方法：修补技术包括用环扎式动脉瘤夹缝合和覆盖动脉瘤。一次大的撕裂破坏了血管的管状结构，仅使用环绕夹修复是不够的。在撕裂处缝了两针，使破裂的动脉重新形成管状结构。然后用Surgicel(新泽西州萨默维尔的ethcon，Inc.)和纤维蛋白胶覆盖病变。当应用Surgicel和纤维蛋白胶时，颈内动脉远端的临时夹子被移除一段时间，允许逆行血流提供维持血管管状结构所需的反作用力。结果：这种方法只需要很短的闭塞时间就可以修复动脉，从而有助于避免缺血并发症。患者醒来时有一过性偏瘫，但恢复迅速。结论：这种技术对于修复动脉瘤样基底部的撕裂是有用的，特别是如果撕裂很大。
OBJECTIVE: An aneurysm can produce large defects in the parent vessel if the aneurysm tears at the neck of the vessel. The authors present a technique to repair a tear at the base of a blister-like aneurysm encountered during microsurgical clipping of an anterior wall aneurysm of the internal carotid artery.METHODS: The repair technique involved suturing and covering the aneurysm with an encircling aneurysm clip. A large tear had destroyed the vessel's tubular structure, and repair was not sufficient using an encircling clip alone. Two microsuture stitches were placed on the tear, so that a split artery re-formed a tubular structure. The lesion was then covered with Surgicel (Ethicon, Inc., Somerville, NJ) and fibrin glue. When the Surgicel and fibrin glue were applied, the temporary clip on the distal internal carotid artery was removed for a moment, allowing retrograde blood flow to provide the counterforce necessary to maintain the vessel's tubular structure. An encircling clip was then applied to cover the entire circumference of the lesion.RESULTS: This method required only a short occlusion time for arterial repair, thus helping avoid ischemic complications. The patient awoke with transient hemiparesis, but recovery was prompt.CONCLUSION: This technique is useful for repairing an aneurysmal tear at its base, especially if the tear is large.