摘要：

复合手术融合显微神经外科开放手术与血管内治疗的优势, 可在复合手术室内完成序贯或同步的多模态操作, 为复杂脑血管病提供“一站式”精准诊断与治疗。本文对复合手术在颅内动脉瘤、脑动静脉畸形、硬脑膜动静脉瘘、症状性慢性颈内动脉闭塞及急性脑血管病中的应用现状及技术进展进行回顾, 有助于临床医师了解其发展历程及面临挑战。尽管复合手术目前仍面临感染-抗凝双重风险、辐射暴露、设备与技术壁垒等挑战, 但随着流程标准化、影像智能化及多学科深度融合, 其在缺血性脑血管病、高级别脑动静脉畸形及急性脑血管病中的应用价值将进一步突显, 有望成为复杂脑血管病治疗的核心范式。

关键词: 颅内动脉瘤, 颅内动静脉畸形, 颈动脉血栓形成, 颈内动脉, 神经外科手术, 颈动脉内膜切除术, 球囊和椭圆囊, 支架

Abstract:

Hybrid operation integrates the strengths of open microsurgical neurosurgery with endovascular treatment, enabling sequential or simultaneous multimodal procedures within a hybrid operating suite to deliver "one-stop" precision diagnosis and treatment for complex cerebrovascular diseases. A review of the current status and technical advances of hybrid operation in intracranial aneurysm, cerebral arteriovenous malformation (CAVM), dural arteriovenous fistula (DAVF), symptomatic chronic internal carotid artery occlusion (CICAO), and acute cerebrovascular diseases will help clinicians appreciate its evolution and the challenges it faces. Although hybrid operation still contends with the dual risks of infection and anticoagulation, radiation exposure, and equipment and technical barriers, the standardization of workflows, intelligent imaging, and deeper multidisciplinary integration will further underscore its value in ischemic cerebrovascular diseases, high - grade cerebral arteriovenous malformation, and acute cerebrovascular diseases, positioning it to become the central paradigm in the diagnosis and treatment of complex cerebrovascular diseases.

Key words: Intracranial aneurysm, Intracranial arteriovenous malformations, Carotid artery thrombosis, Carotid artery, internal, Neurosurgical procedures, Endarterectomy, carotid, Saccule and utricle, Stents