The Journal of Visualized Experiments (JoVE) is a peer reviewed, PubMed-indexed video journal. Our mission is to increase the productivity of scientific research.
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The Journal of Visualized Experiments (JoVE) is a peer reviewed, PubMed-indexed video journal. Our mission is to increase the productivity of scientific research.
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Department of Neurosurgery , Havard Medical School, Massachusetts General Hospital
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Carter, B. S., Farrell, C., Owen, C. Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment. J. Vis. Exp. (31), e1294, doi:10.3791/1294 (2009).
脑动脉瘤是本地化段的颅内血管的异常扩大或气球。这些病变通常发生在动脉壁逐渐弱化的结果母管分支点。后动脉瘤破裂导致蛛网膜下腔出血，脑血管瘤是最常见的检测。这颅内出血的形式进行的第一个月内的死亡率45％的风险破裂后，幸存者往往遇到严重的永久性神经损伤1。最近，由于越来越多地使用先进的成像方式，如MRI和CT扫描，脑血管瘤是经常遇到的包括手术夹闭和弹簧圈栓塞治疗脑动脉瘤破裂和选项前。在这个视频报告中，我们描述了一个大脑中动脉血管流量评估利用超声波血管周围探头瘤的显微手术夹闭。
一个颅内动脉瘤手术夹闭的目标是明确从循环中删除的血流量，同时保留通过家长和远端动脉瘤。通常情况下，在手术显微镜是用来提供改进的可视化和使动脉瘤的成功剥离瘤和安置钛夹在它的基础。剪辑放置不当，可能会导致残余瘤或部分或全部远端动脉闭塞，可能会导致脑梗塞。在动脉瘤手术，术中造影的一些研究已经证明，预测足够的血流量维持在家长和2,3远端动脉直接目视检查的不足之处。尽管它的效用，术中造影进行动脉损伤或中风的风险，其广泛的可用性是有限的4。在这份报告中，我们描述了使用超声波流量探头提供以下的动脉瘤手术夹闭术定量评估血流量。
跨音速流动探头采用过境时间技术测量血流量。探头采用两个传感器或者发送和接收超声波信号在上行和下行方向与血流5。流量计措施波超声旅游的传感器之间的固定距离的运输时间。上游和下游的综合运输时间之间的差异是衡量血流量。进行定量流量测量前在母公司和远端血管动脉瘤夹闭，然后重新评估后的剪辑已经应用，以确保保存血流量6-8。如果血流量减少，然后剪辑可能是必要的调整。看到此视频，手术闭塞是一个大脑中动脉瘤和血液流动的定量评估，使用超声波探头可以通过远端动脉供应大脑的保存流的确认，从而使手术的剪辑放置不当避免神经系统并发症。
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