Neurological Surgery 脳神経外科41巻2号

2013年02月発行

研究

内頚動脈海綿静脈洞部巨大・大型動脈瘤の治療戦略

著者： 大瀧隼也¹ 三上毅¹ 飯星智史¹ 宮田圭¹ 野中雅² 寳金清博³ 三國信啓¹

所属機関： ¹札幌医科大学脳神経外科 ²札幌白石脳神経外科病院 ³北海道大学大学院医学研究科脳神経外科

ページ範囲：P.107 - P.115

Ⅰ．はじめに

　内頚動脈海綿静脈洞部巨大・大型動脈瘤は，直達手術が困難であるため内頚動脈閉塞術が行われる^3,4,7,10,26)．その際，遠位部の局所的脳虚血を予防するために，血行再建術を行う場合がある．血行再建術の必要性については，普遍的もしくは選択的の2つの考え方があるが，後者では術前のバルーン閉塞試験（balloon occlusion test：BOT）の所見により決定されることが多い^3,9,32)．BOTは，主幹動脈の一時遮断や永久閉塞の可否を評価する術前試験であるが，方法は各施設によって異なるのが現状である．本試験自体の合併症や偽陰性の問題もあり^15,18,19)，試験結果に基づいた治療結果に関する分析は，一定の見解が得にくい．今回われわれは，自験例の海綿静脈洞部内頚動脈瘤における術前BOTの結果と治療結果に関して検討し，BOTと血行再建術の意義について文献的考察を加え報告する．

参考文献

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