sibneiroСибнейроSibneuro3033-649X3033-6805Bervitskiy Anatoliy Vladimirovich10.64265/sibneuro-2025-1-1-57-67sibneiro-21Research ArticleСтатьиПрименение страховочного экстра-интракраниального шунта при удалении менингиомы переднего наклоненного отростка (описание клинического случая и обзор литературы)The use of safety extra-intracranial anastomosis in the removal of meningioma of the anterior oblique process (description of the clinical case and literature review)https://orcid.org/0009-0004-1461-553XФедоренкоА. Д.FedorenkoA. D.

Федоренко Аркадий Дмитриевич – клинический ординатор по профилю нейрохирургия кафедры неврологии и нейрохирургии 

ул. Митрофана Седина, д. 4, г. Краснодар, 350063 

Arkady D. Fedorenko – Clinical Resident of the Department of Neurology and Neurosurgery 

Mitrofana Sedina str., 4, Krasnodar, 350063 

arkadiy2000a1@gmail.comhttps://orcid.org/0000-0001-8731-3218ЗабунянГ. А.ZabunyanG. A.

Забунян Грант Андроникович – врач-онколог, пластический хирург, челюстно-лицевой хирург, заведующий хирургическим отделением № 3 

ул. 1 Мая, д. 167, Краснодар, 350086 

Grant A. Zabunyan – Oncologist, Plastic Surgeon, Maxillofacial Surgeon, Head of the Surgery Department No. 3 

1 Maya str., 167, Krasnodar, 350086 

grant-z@yandex.ruhttps://orcid.org/0000-0002-4831-1874ЛитвиненкоД. В.LitvinenkoD. V.

Литвиненко Дмитрий Викторович – кандидат медицинских наук, врач-нейрохирург нейрохирургического отделения № 2 

ул. 1 Мая, д. 167, Краснодар, 350086 

Dmitry V. Litvinenko – Cand. Sci. (Med.), Neurosurgeon of the Neurosurgery Department No. 2 

1 Maya str., 167, Krasnodar, 350086 

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

Ткачев Вячеслав Валерьевич – доктор медицинских наук, доцент, врач-нейрохирург, заведующий нейрохирургическим отделением № 2 

ул. 1 Мая, д. 167, Краснодар, 350086 

Vyacheslav V. Tkachev – Dr. Sci. (Med.), Associate Professor, Neurosurgeon, Head of the Neurosurgery Department No. 2 

1 Maya str., 167, Krasnodar, 350086 

tkachovvv@yandex.ruФГБОУ ВО «Кубанский государственный медицинский университет» Минздрава РоссииKuban State Medical UniversityГБУЗ «Научно-исследовательский институт – Краевая клиническая больница № 1 имени профессора С.В. Очаповского» Минздрава Краснодарского краяRegional Clinical Hospital No. 1 named after Professor S.V. Ochapovsky202514102025115767Copyright © Федоренко А.Д., Забунян Г.А., Литвиненко Д.В., Ткачев В.В., 20252025Федоренко А.Д., Забунян Г.А., Литвиненко Д.В., Ткачев В.В.Fedorenko A.D., Zabunyan G.A., 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.sibneurojournal.com/jour/article/view/21Введение

Введение. Степень инвазии менингиом переднего наклоненного отростка в магистральные сосуды головного мозга прямо коррелирует с радикальностью их удаления. Создание страховочных обходных артериальных шунтов – один из путей повышения радикальности операций.

Описание случая

Описание случая. Пациентка 36 лет поступила в ГБУЗ «Научно-исследовательский институт – Краевая клиническая больница № 1 имени профессора С.В. Очаповского» Минздрава Краснодарского края с диагнозом: менингиома правого переднего наклоненного отростка. Решено выполнить радикальное удаление опухоли с наложением страховочного экстра-интракраниального шунта между лучевой артерией левой руки и правой средней мозговой артерией. После удаления опухоли выявлено стенозирование внутренней сонной артерии, в связи с чем выполнена конверсия временного экстра-интракраниального шунта в постоянный. На контрольной магнитно-резонансной томографии признаков остаточной опухоли не выявлено, церебральный кровоток не скомпрометирован. Пациентка выписана в удовлетворительном состоянии.

Обсуждение

Обсуждение. Вовлечение магистральных церебральных артерий в опухолевый узел снижает радикальность удаления новообразований и уменьшает продолжительность безрецидивного периода. Создание обходного артериального шунта – один из методов церебральной реваскуляризации при удалении опухолей основания черепа с инвазией в магистральные сосуды головного мозга. Нами использована методика, позволяющая на этапе удаления опухоли обеспечить временную ретроградную перфузию артерий каротидного бассейна при вынужденном прекращении в них антеградного кровотока, а при необходимости – выполнять постоянное обходное шунтирование различного объема кровотока участков артерии, пораженного опухолью.

Introduction

Introduction. The degree of invasion of meningiomas of the anterior oblique process into the main vessels of the brain directly correlates with the radicality of their removal. The creation of safety bypass arterial shunts is one of the ways to increase the radicality of operations.

Case description

Case description. A 36-year-old patient was admitted to the Regional Clinical Hospital No. 1 named after Professor S.V. Ochapovsky with a diagnosis of meningioma of the right anterior oblique process. It was decided to perform a radical removal of the tumor with the imposition of an extra-intracranial anastomosis between the radial artery of the left arm and the right middle cerebral artery. After removal of the tumor, stenosis of the internal carotid artery was revealed, and therefore a temporary extraintracranial anastomosis was converted into a permanent shunt. The control MRI showed no signs of a residual tumor, and the cerebral blood flow was not compromised. The patient was discharged in a satisfactory condition.

Discussion

Discussion. The involvement of the main cerebral arteries in the tumor node reduces the radical removal of neoplasms and reduces the duration of the recurrence-free period. The creation of a bypass arterial shunt is one of the methods of cerebral revascularization in the removal of tumors of the base of the skull with invasion into the main vessels of the brain. We used a technique that allows, at the stage of tumor removal, to provide temporary retrograde perfusion of the carotid basin arteries with the forced cessation of antegrade blood flow in them, and, if necessary, to perform permanent bypass bypass surgery of various volumes of blood flow in areas of the artery affected by the tumor.

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