IC-PC大型動脈瘤に対する前床突起切除 適応，方法，注意点
「はじめに」 内頚動脈-後交通動脈分岐部動脈瘤(以下, IC-PC動脈瘤)はdistal trans-sylvian approach, もしくは外側からの視野を確保し, retro-carotid spaceを十分展開するanterior temporal approachにて, 比較的容易に母血管確保, 動脈瘤クリッピング可能なことが多い. しかし, 大きさ, 向き, 頭蓋内内頚動脈の走行や角度により, 工夫が必要なことがある. 同部位のコイル塞栓術の成績は良好であるが, 再開通の問題がある. また, broad neck, 真の後交通動脈瘤, fetal typeのIC-PC動脈瘤などに...
Saved in:
| Published in | 脳卒中の外科 Vol. 42; no. 4; pp. 288 - 293 |
|---|---|
| Main Authors | , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本脳卒中の外科学会
2014
日本脳卒中の外科学会 |
| Online Access | Get full text |
| ISSN | 0914-5508 1880-4683 |
| DOI | 10.2335/scs.42.288 |
Cover
| Abstract | 「はじめに」 内頚動脈-後交通動脈分岐部動脈瘤(以下, IC-PC動脈瘤)はdistal trans-sylvian approach, もしくは外側からの視野を確保し, retro-carotid spaceを十分展開するanterior temporal approachにて, 比較的容易に母血管確保, 動脈瘤クリッピング可能なことが多い. しかし, 大きさ, 向き, 頭蓋内内頚動脈の走行や角度により, 工夫が必要なことがある. 同部位のコイル塞栓術の成績は良好であるが, 再開通の問題がある. また, broad neck, 真の後交通動脈瘤, fetal typeのIC-PC動脈瘤などに対しては, クリッピング術に優位性がある. 前床突起切除(いわゆるDolenc approach)は傍前床突起部内頚動脈瘤(以下, C3動脈瘤)クリッピングの際に必須の手技である. IC-PC動脈瘤に対しても, 母血管確保困難な場合, 頚部における頚動脈確保のほか, この前床突起切除も有用である. |
|---|---|
| AbstractList | 「はじめに」 内頚動脈-後交通動脈分岐部動脈瘤(以下, IC-PC動脈瘤)はdistal trans-sylvian approach, もしくは外側からの視野を確保し, retro-carotid spaceを十分展開するanterior temporal approachにて, 比較的容易に母血管確保, 動脈瘤クリッピング可能なことが多い. しかし, 大きさ, 向き, 頭蓋内内頚動脈の走行や角度により, 工夫が必要なことがある. 同部位のコイル塞栓術の成績は良好であるが, 再開通の問題がある. また, broad neck, 真の後交通動脈瘤, fetal typeのIC-PC動脈瘤などに対しては, クリッピング術に優位性がある. 前床突起切除(いわゆるDolenc approach)は傍前床突起部内頚動脈瘤(以下, C3動脈瘤)クリッピングの際に必須の手技である. IC-PC動脈瘤に対しても, 母血管確保困難な場合, 頚部における頚動脈確保のほか, この前床突起切除も有用である. |
| Author | 久須美, 真理 福島, 孝徳 隈部, 俊宏 岡, 秀宏 佐藤, 澄人 |
| Author_xml | – sequence: 1 fullname: 福島, 孝徳 organization: Duke大学 脳神経外科 – sequence: 1 fullname: 岡, 秀宏 organization: 北里大学医学部 脳神経外科 – sequence: 1 fullname: 隈部, 俊宏 organization: 北里大学医学部 脳神経外科 – sequence: 1 fullname: 佐藤, 澄人 organization: 北里大学医学部 脳神経外科 – sequence: 1 fullname: 久須美, 真理 organization: 北里大学医学部 脳神経外科 |
| BookMark | eNo1kD9Lw0AYxg-pYK1d_B6pb-5Pejc4SNBaKOjQ_bhcr5qYJiWpg2NFsFocBbs4FQQdnERw8MuE0PotvFJdngce3vf3wLONKkmaGIR2XWhgQthervMGxQ3M-QaqupyDQz1OKqgKwqUOY8C3UD3PwwAwcT0biirCbd859cv5S_k8LaePy5vJ4mlejN_K9-9iPCuup-XdQ_l1v3gdLz8-y8ntz2y-gzb7Ks5N_c9rqHt02PWPnc5Jq-0fdJwIUwKOMAYoIwJzo5gQoBh4XFDgttkANz0TcNXjxjNNr89UE7SnFQT2IlBNrEkNtdbYgemFWsVpEoeJkVF6mSW2VuohzUdZeiExuFQCUAzWXFeCHcCKIBgLxjFY0v6aFOUjdWbkMAsHKruSKhuFOjbS7iYplnQlq9__XJ-rTEaK_ALqHXXt |
| ContentType | Journal Article |
| Copyright | 2014 一般社団法人 日本脳卒中の外科学会 |
| Copyright_xml | – notice: 2014 一般社団法人 日本脳卒中の外科学会 |
| CorporateAuthor | 北里大学医学部脳神経外科 Duke大学脳神経外科 |
| CorporateAuthor_xml | – name: 北里大学医学部脳神経外科 – name: Duke大学脳神経外科 |
| DOI | 10.2335/scs.42.288 |
| DatabaseTitleList | |
| DeliveryMethod | fulltext_linktorsrc |
| Discipline | Medicine |
| EISSN | 1880-4683 |
| EndPage | 293 |
| ExternalDocumentID | cp4strok_2014_004204_011_0288_02932295820 article_scs_42_4_42_288_article_char_ja |
| GroupedDBID | 123 2WC ABJNI ALMA_UNASSIGNED_HOLDINGS CS3 JSF KQ8 MOJWN OK1 RJT |
| ID | FETCH-LOGICAL-j2430-9ee0453928ea5990a50689408609e08edeb8ad8e6e76f5a70c6ca0b940ba72c3 |
| ISSN | 0914-5508 |
| IngestDate | Thu Jul 10 16:15:50 EDT 2025 Wed Sep 03 06:10:56 EDT 2025 |
| IsDoiOpenAccess | true |
| IsOpenAccess | true |
| IsPeerReviewed | false |
| IsScholarly | true |
| Issue | 4 |
| Language | Japanese |
| LinkModel | OpenURL |
| MergedId | FETCHMERGED-LOGICAL-j2430-9ee0453928ea5990a50689408609e08edeb8ad8e6e76f5a70c6ca0b940ba72c3 |
| OpenAccessLink | https://www.jstage.jst.go.jp/article/scs/42/4/42_288/_article/-char/ja |
| PageCount | 6 |
| ParticipantIDs | medicalonline_journals_cp4strok_2014_004204_011_0288_02932295820 jstage_primary_article_scs_42_4_42_288_article_char_ja |
| PublicationCentury | 2000 |
| PublicationDate | 20140000 |
| PublicationDateYYYYMMDD | 2014-01-01 |
| PublicationDate_xml | – year: 2014 text: 20140000 |
| PublicationDecade | 2010 |
| PublicationTitle | 脳卒中の外科 |
| PublicationTitleAlternate | Surg. Cereb. Stroke |
| PublicationYear | 2014 |
| Publisher | 一般社団法人 日本脳卒中の外科学会 日本脳卒中の外科学会 |
| Publisher_xml | – name: 一般社団法人 日本脳卒中の外科学会 – name: 日本脳卒中の外科学会 |
| References | 2) Chi JH, Sughrue M, Kunwar S, et al: The “yo-yo” technique to prevent cerebrospinal fluid rhinorrhea after anterior clinoidectomy for proximal internal carotid artery aneurysms. Neurosurgery 59: ONS101-107; discussion ONS101-107, 2006 16) Wanibuchi M, Friedman A, Fukushima T: Frontotemporal orbitozygomatic transcavernous approach, in Wanibuchi M (ed) : Photo Atlas of Skull Base Dissection. New York: Thieme Medical Publishers, Inc, 2009, pp122-143 4) Dolenc VV: A combined epi- and subdural direct approach to carotid-ophthalmic artery aneurysms. J Neurosurg 62: 667-672, 1985 3) Day JD, Giannotta SL, Fukushima T: Extradural temporopolar approach to lesions of the upper basilar artery and infrachiasmatic region. J Neurosurg 81: 230-235, 1994 11) Park SK, Shin YS, Lim YC, et al: Preoperative predictive value of the necessity for anterior clinoidectomy in posterior communicating artery aneurysm clipping. Neurosurgery 65: 281-285; discussion 285-286, 2009 13) 清水重利，山道 茜，谷岡 悟，ほか：前床突起切除（anterior clinoidectomy）を施行した内頚動脈─後交通動脈分岐部動脈瘤（IC-PC AN）の検討．脳卒中の外科 41: 137-142, 2013 9) Noguchi A, Balasingam V, Shiokawa Y, et al: Extradural anterior clinoidectomy. Technical note. J Neurosurg 102: 945-950, 2005 7) 石川達哉，上山博康，数又 研，ほか：IC-PC aneurysmの解剖と手術．脳外誌13 (5) : 382-388, 2004 12) Sanai N, Caldwell N, Englot DJ, et al: Advanced technical skills are required for microsurgical clipping of posterior communicating artery aneurysms in the endovascular era. Neurosurgery 71: 285-294; discussion 294-285, 2012 6) Golshani K, Ferrell A, Zomorodi A, et al: A review of the management of posterior communicating artery aneurysms in the modern era. Surg Neurol Int 1: 88, 2010 5) Fukushima T, Nonaka Y: Cavernous sinus approach, in Fukushima T, Nonaka Y (eds) : Fukushima Manual of Skull Base Dissection, ed Third. Raleigh, NC: AF-Neuro Video, Inc, 2010, pp112-135 8) Korosue K, Heros RC: “Subclinoid” carotid aneurysm with erosion of the anterior clinoid process and fatal intraoperative rupture. Neurosurgery 31: 356-359; discussion 359-360, 1992 1) Barnett SL, Whittemore B, Thomas J, et al: Intradural clinoidectomy and postoperative headache in patients undergoing aneurysm surgery. Neurosurgery 67: 906-909; discussion 910, 2010 15) Velat GJ, Zabramski JM, Nakaji P, et al: Surgical management of giant posterior communicating artery aneurysms. Neurosurgery 71: 43-50; discussion 51, 2012 14) Spektor S, Dotan S, Mizrahi CJ: Saftey of drilling for clinoidectomy and optic canal unroofing in anterior skull base surgery. Acta Neurochir 155: 1017-1024, 2013 10) O’Shaughnessy BA, Getch CC, Bendok BR, et al: Surgical management of unruptured posterior carotid artery wall aneurysms. Neurosurg Focus 15: E9, 2003 |
| References_xml | – reference: 14) Spektor S, Dotan S, Mizrahi CJ: Saftey of drilling for clinoidectomy and optic canal unroofing in anterior skull base surgery. Acta Neurochir 155: 1017-1024, 2013 – reference: 16) Wanibuchi M, Friedman A, Fukushima T: Frontotemporal orbitozygomatic transcavernous approach, in Wanibuchi M (ed) : Photo Atlas of Skull Base Dissection. New York: Thieme Medical Publishers, Inc, 2009, pp122-143 – reference: 7) 石川達哉，上山博康，数又 研，ほか：IC-PC aneurysmの解剖と手術．脳外誌13 (5) : 382-388, 2004 – reference: 5) Fukushima T, Nonaka Y: Cavernous sinus approach, in Fukushima T, Nonaka Y (eds) : Fukushima Manual of Skull Base Dissection, ed Third. Raleigh, NC: AF-Neuro Video, Inc, 2010, pp112-135 – reference: 11) Park SK, Shin YS, Lim YC, et al: Preoperative predictive value of the necessity for anterior clinoidectomy in posterior communicating artery aneurysm clipping. Neurosurgery 65: 281-285; discussion 285-286, 2009 – reference: 4) Dolenc VV: A combined epi- and subdural direct approach to carotid-ophthalmic artery aneurysms. J Neurosurg 62: 667-672, 1985 – reference: 9) Noguchi A, Balasingam V, Shiokawa Y, et al: Extradural anterior clinoidectomy. Technical note. J Neurosurg 102: 945-950, 2005 – reference: 15) Velat GJ, Zabramski JM, Nakaji P, et al: Surgical management of giant posterior communicating artery aneurysms. Neurosurgery 71: 43-50; discussion 51, 2012 – reference: 2) Chi JH, Sughrue M, Kunwar S, et al: The “yo-yo” technique to prevent cerebrospinal fluid rhinorrhea after anterior clinoidectomy for proximal internal carotid artery aneurysms. Neurosurgery 59: ONS101-107; discussion ONS101-107, 2006 – reference: 3) Day JD, Giannotta SL, Fukushima T: Extradural temporopolar approach to lesions of the upper basilar artery and infrachiasmatic region. J Neurosurg 81: 230-235, 1994 – reference: 1) Barnett SL, Whittemore B, Thomas J, et al: Intradural clinoidectomy and postoperative headache in patients undergoing aneurysm surgery. Neurosurgery 67: 906-909; discussion 910, 2010 – reference: 10) O’Shaughnessy BA, Getch CC, Bendok BR, et al: Surgical management of unruptured posterior carotid artery wall aneurysms. Neurosurg Focus 15: E9, 2003 – reference: 6) Golshani K, Ferrell A, Zomorodi A, et al: A review of the management of posterior communicating artery aneurysms in the modern era. Surg Neurol Int 1: 88, 2010 – reference: 12) Sanai N, Caldwell N, Englot DJ, et al: Advanced technical skills are required for microsurgical clipping of posterior communicating artery aneurysms in the endovascular era. Neurosurgery 71: 285-294; discussion 294-285, 2012 – reference: 8) Korosue K, Heros RC: “Subclinoid” carotid aneurysm with erosion of the anterior clinoid process and fatal intraoperative rupture. Neurosurgery 31: 356-359; discussion 359-360, 1992 – reference: 13) 清水重利，山道 茜，谷岡 悟，ほか：前床突起切除（anterior clinoidectomy）を施行した内頚動脈─後交通動脈分岐部動脈瘤（IC-PC AN）の検討．脳卒中の外科 41: 137-142, 2013 |
| SSID | ssib023160919 ssj0041830 ssib058493970 ssib005901896 ssib017628741 ssib000872179 ssib002484435 |
| Score | 1.940483 |
| Snippet | 「はじめに」 内頚動脈-後交通動脈分岐部動脈瘤(以下, IC-PC動脈瘤)はdistal trans-sylvian approach, もしくは外側からの視野を確保し, retro-carotid spaceを十分展開するanterior temporal approachにて, 比較的容易に母血管確保,... |
| SourceID | medicalonline jstage |
| SourceType | Publisher |
| StartPage | 288 |
| Subtitle | 適応，方法，注意点 |
| Title | IC-PC大型動脈瘤に対する前床突起切除 |
| URI | https://www.jstage.jst.go.jp/article/scs/42/4/42_288/_article/-char/ja http://mol.medicalonline.jp/en/journal/download?GoodsID=cp4strok/2014/004204/011&name=0288-0293j |
| Volume | 42 |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| ispartofPNX | 脳卒中の外科, 2014, Vol.42(4), pp.288-293 |
| link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV3NaxQxFB9qBRFE_MT6RQ_mODWTSTLJzcx2lqpUFCr0Nkxms4cV29JuL94qgtXiUbAXTwVBD55E8eA_U4bW_8KXj92dqgftJZvN_PLyPmb2vZedJFF0ixKDda-vY20ki2nSr2LJKxlzaYSupe5jd3TC4gO-8JjeW2bLUye-td5a2hzqufrZX9eVHMeq0AZ2tatk_8OyY6LQAHWwL5RgYSj_ycZ3O_HDDioYUhSpzFZkgURuK1BKhgqBBASLAhUZksLCihRiR6QcRnVRXoQWKV2FjLpLJOZtJVdIKNtdKQsDgjk0urGArICKtH0VbUe5Ydw8dbB5JAkq4CswMD9ioAhsS-6IA3tj27sGjkTXjZ-inNv7wOGBlOeqgAsTPDQQpBIPc9QEdnjQRncCA06VUwYIlyIlPB4Y6zoZ_8DDFRgQW2lkZpl1eG5HB-nsZYXCPEeYN0kmM6ZBYuG6w6Cq41ijTuVgqByp1BFLnaECMUffDsZcpeO6HUeZQV2gRwvugOTtSdmExpAzeo9kvEuCX9iYcn_cz8hnUdJ6NmnbAQnRimWIP33ydzdJ0pS5gz035iiZG3c5su14uKlLAJWUlNQWgCxH7XZRYDmAzOQkybLEvkx7_1E7sM9IkrUDb0Hbgbld8SwmGz0m4JJFNgnMIengoItxf4iSJQTOeBRjUXBEbvZ0pC-_8bCV6_ZEKggqB5Bi2b0zzjz1f3v67WdaEeTSuehsSP1mlRftfDQ1qC5EpxbDyy0XI-Ie52bvQ_N-p9l5e_hi--Dd3v7Wp-bzj_2t3f3nO82rN8331wcftw6_fG22X_7c3bsULXWLpc5CHI40iQeEpjiWxkAOBTmJMBWDQLBimAtJsQBxDRamZ7SoesJwk_E-qzJc87rCGhC6ykidXo6mV1ZXzJVoVrKq1sKudO8xqgXoV_Z7GevrXsp4reuZiHvhyzW_bU35jxadie4cUVYZfvA2ynqNbgzXV5-U9nEqrbvH8JEkJbZkMNxshEgGKcXV4459LTptafspzuvR9HB909yAoH-ob7r76xdeO8jB |
| linkProvider | Colorado Alliance of Research Libraries |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=IC-PC%E5%A4%A7%E5%9E%8B%E5%8B%95%E8%84%88%E7%98%A4%E3%81%AB%E5%AF%BE%E3%81%99%E3%82%8B%E5%89%8D%E5%BA%8A%E7%AA%81%E8%B5%B7%E5%88%87%E9%99%A4&rft.jtitle=%E8%84%B3%E5%8D%92%E4%B8%AD%E3%81%AE%E5%A4%96%E7%A7%91&rft.au=%E7%A6%8F%E5%B3%B6%2C+%E5%AD%9D%E5%BE%B3&rft.au=%E5%B2%A1%2C+%E7%A7%80%E5%AE%8F&rft.au=%E9%9A%88%E9%83%A8%2C+%E4%BF%8A%E5%AE%8F&rft.au=%E4%BD%90%E8%97%A4%2C+%E6%BE%84%E4%BA%BA&rft.date=2014&rft.pub=%E4%B8%80%E8%88%AC%E7%A4%BE%E5%9B%A3%E6%B3%95%E4%BA%BA+%E6%97%A5%E6%9C%AC%E8%84%B3%E5%8D%92%E4%B8%AD%E3%81%AE%E5%A4%96%E7%A7%91%E5%AD%A6%E4%BC%9A&rft.issn=0914-5508&rft.eissn=1880-4683&rft.volume=42&rft.issue=4&rft.spage=288&rft.epage=293&rft_id=info:doi/10.2335%2Fscs.42.288&rft.externalDocID=article_scs_42_4_42_288_article_char_ja |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0914-5508&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0914-5508&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0914-5508&client=summon |