颅内动脉瘤夹闭术后残留和复发的处理

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【中图分类号】 R743 【文献标志码】 A 【文章编号】1672-7770（2025）02-0126-05

Abstract： Objective To explore the characteristics of residual and recurrent intracranial aneurysms after clipping，as well as the difficulties and efficacy of re-treatment. MethodsA total of 15 patients with intracranial residual and recurrent aneurysms after clipping admitted to Department of Neurosurgery， Leshan Geriatric Hospital from January 2014 to January 2024 were retrospectively analyzed and the relevant literature were reviewed. ResultsAt the first postoperative follow-up，7 cases were found to be completely clipped and 8 cases showed small remnants. The shortest time from aneurysm clipping to recurrence was 1 month， and the longest was 20 years with an average of 50.5 months. The reasons for the retreatment of aneurysms included the recurrence and enlargement of aneurysms after complete clipping， as well as the progressive enlargement of residual aneurysms. Re-clipping was performed in 10 cases of recurrent aneurysms， 2 of them suffred postoperative cerebral infarction. The remaining 5 patients with endovascular embolization recovered well. Conclusions The residual aneurysms have a higher risk of regrowth and rupture. As a result， they should be followed closely and regularly. Interventional embolization is a safe and efective treatment for recurrent aneurysms after clipping. For cases unsuitable for interventional embolization， surgical treatment needs to overcome the technical diffculties of reoperation and master various skills of vascular surgery.

Key words： intracranial aneurysm； operative technique； recurrent aneurysm； residual aneurysm虽然血管内治疗在颅内动脉瘤的治疗中占有越来越大的比例，但动脉瘤夹闭手术仍然在动脉瘤治疗中具有重要的作用[1]。（剩余9274字）