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首页> 外文期刊>Neurosurgery >New method for obliterative treatment of an anterior wall aneurysm in the internal carotid artery: encircling silicone sheet clip procedure--technical case report.
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New method for obliterative treatment of an anterior wall aneurysm in the internal carotid artery: encircling silicone sheet clip procedure--technical case report.

机译：闭塞治疗颈内动脉前壁动脉瘤的新方法：环绕硅胶片夹术-技术案例报道。

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OBJECTIVE AND IMPORTANCE: Aneurysms on the anterior surface of the internal carotid artery (ICA) have been shown to be somewhat different from ordinary berry aneurysms because they are rather small, grow rapidly in a short time, and easily lead to rupture, especially during surgery. The most difficult problem is that this type of aneurysm cannot be eliminated easily by an ordinary clipping procedure without causing apparent arterial stenosis or occlusion. CLINICAL PRESENTATION: A 52-year-old man experienced a subarachnoid hemorrhage because of a ruptured aneurysm located on the anterior surface of the ICA. The tiny aneurysmal body, which was covered with a layer of brain tissue, was successfully exposed. The ICA seemed to be atherosclerotic, and the aneurysmal portion was solitary and had a reddish color. TECHNIQUE: A large silicone sheet encircling clip (Vascwrap; Mizuho Ikakogyo Co., Ltd., Tokyo, Japan) was selected for this patient. The proximal margin of the silicone sheet was incised with a V-shaped cut, and the middle part of the sheet, which covered the diagonal part of the ICA, was trimmed to make it shorter. The blade of the fenestrated clip was applied to obliterate the aneurysm and was attached to the normal arterial wall together with this modified Vascwrap sheet to create a small space between the normal arterial wall and the surrounding Vascwrap sheet. Then tiny pieces of Teflon fiber (E.I. duPont de Nemours and Co., Wilmington, DE) was inserted from both margins, and the whole Vascwrap sheet was sealed with fibrin glue to ensure good adhesion. CONCLUSION: This method seemed adequate in treating this difficult aneurysm without causing postoperative regrowth or occlusion of the patient's ICA.
机译：目的和重要性：颈内动脉（ICA）前表面的动脉瘤已显示出与普通浆果动脉瘤有些不同，因为它们很小，在短时间内迅速生长，并且容易导致破裂，尤其是在手术过程中。最困难的问题是，在不引起明显的动脉狭窄或闭塞的情况下，这种动脉瘤不能通过普通的钳夹程序轻松消除。临床表现：一名52岁的男子由于位于ICA前表面的动脉瘤破裂而经历了蛛网膜下腔出血。覆盖了一层脑组织的微小动脉瘤体已成功暴露。 ICA似乎是动脉粥样硬化，动脉瘤部分是孤立的，呈红色。方法：为该患者选择了一个大的硅胶片围夹（Vascwrap; Mizuho Ikakogyo Co.，Ltd。，日本东京）。用V形切口切开硅树脂片的近端边缘，并修整覆盖ICA对角线部分的片的中间部分以使其更短。开窗的夹子的刀片被用来消除动脉瘤，并与这种改良的Vascwrap薄板一起固定在正常动脉壁上，从而在正常动脉壁和周围的Vascwrap薄板之间形成一个很小的空间。然后从两个边缘插入特氟隆纤维的小块（E.I. duPont de Nemours and Co.，威尔明顿），并用纤维蛋白胶密封整个Vascwrap片，以确保良好的粘合性。结论：该方法似乎足以治疗该困难的动脉瘤，而不会引起术后ICA的再生或闭塞。

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