Surgical treatment of spindle aneurysms in V4 segment of vertebral artery
10.3760/j.issn.1673-4904.2019.08.011
- VernacularTitle:椎动脉V4段梭形动脉瘤的手术治疗
- Author:
Mengqing HU
1
;
Fangjun LIU
;
Hai QIAN
;
Yuming SUN
;
Xiang′en SHI
Author Information
1. 首都医科大学三博脑科医院神经外科
- Keywords:
Intracranial aneurysm;
Surgical procedures,operative;
Vertebral artery V4 segment
- From:
Chinese Journal of Postgraduates of Medicine
2019;42(8):706-710
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the surgical treatment of spindle aneurysms in V4 segment of vertebral artery. Methods The clinical data, surgical methods and prognosis of 6 patients with V4 spindle aneurysms of vertebral artery admitted from 2011 to November 2018 in Sanbo Brain Hospital were retrospectively analyzed,Results There were 4 males and 2 females aged from 45 to 65 years. Aneurysm rupture and bleeding occurred in 3 cases. Far lateral approach was used in all patients. One case was clipped with window aneurysms, 2 cases were treated with occipital artery (OA)- posterior inferior cerebellar artery (PICA) bypass, and 3 cases were treated with vertebral artery occlusion. Postoperative patients were generally in good condition. Postoperative CT arteriography confirmed that the bypass vessels were unobstructed in 2 cases. All vertebral aneurysms were treated satisfactorily and PICA arteries were preserved. Tracheotomy was performed in 5 patients (1 case was incised before operation). Three patients were removed 3 months after operation. The Glasgow Prognosis Score (GOS) was 4 points. Long-term tracheotomy was performed in 1 case, and GOS score was 3 points. Two patients died 4 months and 3 years after operation. Conclusions Craniotomy is an important method for the treatment of spindle aneurysm of V4 segment of vertebral artery. Different surgical methods should be selected according to the size of the aneurysm, the relationship between the location of the aneurysm and PICA, and the compensation of the vertebral artery.
