inovmedИнновационная медицина КубаниInnovative Medicine of Kuban2541-9897Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 110.35401/2541-9897-2024-9-2-115-123inovmed-853Research ArticleОБЗОРЫREVIEWSСовременное состояние проблемы микрохирургии аневризм офтальмического сегмента внутренней сонной артерииCurrent State of Microsurgical Treatment of Aneurysms of the Ophthalmic Segment of the Internal Carotid Arteryhttps://orcid.org/0009-0001-2039-7629СеверИ. Н.SeverI. N.

Север Ирина Николаевна, аспирантка кафедры нервных болезней и нейрохирургии

Краснодар

Irina N. Sever, Postgraduate Student, Department of Nervous Diseases and Neurosurgery

Krasnodar

https://orcid.org/0000-0002-4831-1874ЛитвиненкоД. В.LitvinenkoD. V.

Литвиненко Дмитрий Викторович, к. м. н., врачнейрохирург нейрохирургического отделения № 2

ул. 1 мая, 167, Краснодар, 350901

Dmitry V. Litvinenko, Cand. Sci. (Med.), Neurosurgeon, Neurosurgery Unit No. 2

1, ulitsa 1 Maya 167, Krasnodar, 350901

dlmalit73@gmail.comhttps://orcid.org/0000-0002-5600-329XТкачевВ. В.TkachevV. V.

Ткачев Вячеслав Валерьевич, д. м. н., заведующий нейрохирургическим отделением № 2

Краснодар

Vyacheslav V. Tkachev, Dr. Sci. (Med.), Head of the Neurosurgery Unit No. 2, Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1; Associate Professor at the Surgery Department, Kuban State Medical University

Krasnodar

Кубанский государственный медицинский университетРоссияKuban State Medical UniversityRussian FederationНИИ – ККБ № 1 им. С.В. ОчаповскогоРоссияScientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1Russian FederationКубанский государственный медицинский университет; НИИ – ККБ № 1 им. С.В. ОчаповскогоРоссияKuban State Medical University; Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1Russian Federation20243006202402115123Copyright © Север И.Н., Литвиненко Д.В., Ткачев В.В., 20242024Север И.Н., Литвиненко Д.В., Ткачев В.В.Sever I.N., Litvinenko D.V., Tkachev V.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.innovmedkub.ru/jour/article/view/853

В настоящее время наблюдается тенденция к увеличению внутрисосудистых операций на церебральных аневризмах. Однако для части пациентов с разорвавшимися и сложными аневризмами открытые вмешательства остаются методом выбора. Аневризмы офтальмического сегмента внутренней сонной артерии являются той патологией, при которой оптимальный метод выключения остается предметом научных дискуссий. Большое количество публикаций, посвященных оперативному лечению каротидно-офтальмических аневризм, не дает четких рекомендаций в каких случаях использовать микрохирургические или внутрисосудистые технологии. В отечественной литературе отсутствуют работы сравнения результатов открытых и внутрисосудистых операций, в зависимости от клинического варианта течения заболевания. В работе выполнен анализ проблемы микрохирургического лечения каротидно-офтальмических аневризм. Приведены данные по эпидемиологии, вариантам клинического течения, топографо-анатомическим особенностям офтальмических аневризм. Обсуждаются возможности современных методов лучевой диагностики, выбор операционного доступа, техника диссекции аневризм и способы проксимального контроля интраоперационного кровотечения. Систематизированы многочисленные классификации аневризм офтальмического сегмента внутренней сонной артерии.

There is a clear trend towards an increase in the number of endovascular interventions for cerebral aneurysms; however, open surgery remains the method of choice for some patients with ruptured and complex aneurysms. For example, the best treatment method for aneurysms of the ophthalmic segment of the internal carotid artery (ICA) is still up to debate. A large number of publications on surgical treatment of carotid-ophthalmic aneurysms do not give clear guidelines in which cases microsurgical or endovascular techniques should be used. There are no Russian papers comparing the results of open and endovascular surgery depending on the clinical course of the disease. We analyze problems of microsurgical treatment of carotid-ophthalmic aneurysms and present data on epidemiology, variations in clinical course, topographic and anatomical features of aneurysms of the ophthalmic segment. The article discusses possibilities of modern diagnostic radiology, the choice of surgical approach, the technique of aneurysm dissection, and methods of proximal control of intraoperative bleeding. Numerous classifications of aneurysms of the ophthalmic segment of the ICA were systematized.

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The authors declare that there are no conflicts of interest present.