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颌内动脉搭桥术，解决颅内外血管搭桥难点

2018-06-07 彭燕 健康报医生频道

颌内动脉搭桥术报道
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在近日召开的第86届美国神经外科年会(AANS)上，首都医科大学三博脑科医院神经外科专家石祥恩教授应邀做了“颌内动脉搭桥治疗复杂性颅内动脉瘤”的专题报告，专家们对这一手术方式给予了充分肯定。


在近日召开的第86届美国神经外科年会(AANS)上，首都医科大学三博脑科医院神经外科专家石祥恩教授应邀做了“颌内动脉搭桥治疗复杂性颅内动脉瘤”的专题报告，专家们对这一手术方式给予了充分肯定。

在此前的研究中，石祥恩团队发现，颌内动脉在显微外科解剖学上具有距离颅内近、血流量高及与大脑中动脉匹配好的特征。随后，团队尝试在手术中选用该动脉作为供血动脉，用桡动脉移植，治疗颈内动脉系统和椎动脉系统蛇形和巨肠型动脉瘤。此次会议对这种新型搭桥手术方法及术后长期随访结果进行报告后，受到好评。美国康奈尔医学中心、长老会医院颅底神经外科主任A. Bernardo教授认为，这是“新颖的血管搭桥治疗复杂颅内动脉瘤的方法”。

经过八年的临床手术实践并总结经验后，团队于今年3月在《世界神经外科》杂志发表综述文章《颌内动脉搭桥的历史与发展》，杂志配发述评称“颌内动脉与大脑中动脉搭桥是脑血流代替治疗的可靠的范式”。

述评说，既往搭桥方式不能代替颈动脉血流的重建，对有极高的手术病残率和技术复杂的颅内动脉瘤手术治疗，颌内动脉搭桥治疗是一种安全可靠的治疗,是治疗复杂动脉瘤的一次根本性改变。颌内动脉至大脑中动脉搭桥与传统的颈内动脉至大脑中动脉或颈外动脉颈内动脉搭桥有诸多有利之处。颌内动脉到大脑中动脉搭桥是在显微外科手术视野范围内操作，避免了以往颈部二次手术切口；较短的血管移植长度，完全减少了以往过长移植血管扭曲和皮下隧道穿行压迫性阻塞等并发症。离断颧弓外下扩大颞下窝开颅，可清晰识别颌内动脉，得到较好的手术显露，达到安全有效的近心端吻合。在颞浅动脉搭桥不能获得足够血流量或不可利用时，颌内动脉搭桥应该是颅内外搭桥的首要选择。

2014年，这一技术相关论文曾在美国MD Linx对67种相关神经外科专业杂志中选出最有影响前10篇文章中排名第五名。

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    2018-10-28 lanyan20020086

    #颌内动脉搭桥#

    0

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    2018-08-16 12498b3em16(暂无昵称)

    #搭桥#

    0

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    2019-01-16 jiekemin

    #颅内外#

    0

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    2018-06-09 zzc2214

    #搭桥术#

    0

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    2018-06-07 有备才能无患

    在近日召开的第86届美国神经外科年会(AANS)上.首都医科大学三博脑科医院神经外科专家石祥恩教授应邀做了[颌内动脉搭桥治疗复杂性颅内动脉瘤"的专题报告.专家们对这一手术方式给予了充分肯定.

    0

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    2018-06-07 changjiu

    学习一下谢谢

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