CAJ | 학술논문

目的：总结脉络膜前动脉（ AChA ）起始处动脉瘤的诊断、手术治疗技巧、脑缺血等并发症防治。方法以2007年8月-2013年8月我科经显微手术治疗的11例脉络膜前动脉起始处动脉瘤患者临床资料为研究对象，对术前诊断、手术技巧、术后脑缺血并发症防治做回顾性分析。结果11例脉络膜前动脉瘤术前诊断正确8例，3例误诊为后交通动脉瘤。所有动脉瘤均顺利手术夹闭。术后出现脉络膜前动脉供血区梗塞2例。 GOS评分：恢复良好9例，中度残疾1例，重度残疾1例。术后随访3～24个月，无再出血病例。结论术中清晰显露瘤颈与周边血管关系，正确辨认、保护脉络膜前动脉对安全夹闭动脉瘤、预防术后脑缺血性并发症至关重要。
목적：총결맥락막전동맥（ AChA ）기시처동맥류적진단、수술치료기교、뇌결혈등병발증방치。방법이2007년8월-2013년8월아과경현미수술치료적11례맥락막전동맥기시처동맥류환자림상자료위연구대상，대술전진단、수술기교、술후뇌결혈병발증방치주회고성분석。결과11례맥락막전동맥류술전진단정학8례，3례오진위후교통동맥류。소유동맥류균순리수술협폐。술후출현맥락막전동맥공혈구경새2례。 GOS평분：회복량호9례，중도잔질1례，중도잔질1례。술후수방3～24개월，무재출혈병례。결론술중청석현로류경여주변혈관관계，정학변인、보호맥락막전동맥대안전협폐동맥류、예방술후뇌결혈성병발증지관중요。
Objective To summarize the diagnostic and surgical skills involved in the treatment of aneurysm located at the proximal anterior choroidal artery ( AChA) and how to prevent postoperative ischemic complication .Methods E-leven patients with aneurysm located at the proximal anterior choroidal artery were included who were admitted to our hos -pital from August 2007 to August 2013 and underwent microsurgical clipping .Then, preoperative diagnosis , surgical skills and preventive methods to avoid postoperative ischemic events were reviewed retrospectively .Results Among the eleven cases , eight were correctly diagnosed , while the other three were misdiagnosed as posterior communicating artery aneurysm before surgery .All the AChA aneurysms were clipped and two patients manifested infarction in the blood suppl -ying area of AChA.For GOS scores, nine cases had good recovery , one patient presented moderate disability , and one patient was reported severe disability .No bleeding case was reported during 3-24 months of follow-up visits.Conclu-sion It is of importance to recognize aneurysm and identify its relationship with surrounding vessels for microsurgical clipping and better prevention of postoperative ischemic events .