中文摘要：

目的观察脑硬膜颞浅动脉血管融通术（EDAS）联合或不联合血管内栓塞治疗烟雾病合并动脉瘤患者的疗效,并探讨烟雾病合并动脉瘤的治疗策略。方法选择经全脑血管造影证实的烟雾病合并动脉瘤患者27例（28个动脉瘤）。19例以颅内出血发病8,例以脑缺血发病。对位于主干动脉的动脉瘤（10例,11个）,先采用弹簧圈或支架辅助弹簧圈行血管内栓塞,栓塞后7～10 d,再行一侧EDAS。一侧EDAS术后3个月,再行对侧手术治疗。对位于周围动脉的动脉瘤（17例,17个）,若能行栓塞治疗者（9例,9个）,采用弹簧圈或ONYX胶栓塞;若微导管无法到位,行同侧EDAS术（8例,8个）。结果①准备行栓塞的20个（19例）动脉瘤中,共成功栓塞18个,未能行栓塞的有2个（豆纹动脉动脉瘤和脉络膜后动脉动脉瘤各1个）。栓塞术后,3例周围型动脉瘤患者出现对侧肢体肌力下降1,周至3个月内恢复正常。②EDAS术后随访10～60个月,无出血及再出血病例;以缺血发病的患者中,2例EDAS术后3个月内短暂性脑缺血再发作,3个月后未再发作。③对21例（21个动脉瘤）一侧EDAS术后3～15个月行造影检查,显示行栓塞治疗的动脉瘤均无复发（12个）;9个未行栓塞治疗的周围型动脉瘤,8个动脉瘤消失;1个动脉瘤腔内对比剂明显滞留。造影检查的21例均显示颞浅动脉与颅内血管形成良好的沟通。结论血管内栓塞是治疗烟雾病合并动脉瘤的重要手段之一。EDAS手术可能会促进外周型动脉瘤的闭塞。

英文摘要：

Objectives To observe the efficacy of encephalo-duro-arterio-synangiosis （EDAS） or in combination with endovaseular embolization in the treatment of patients with moyamoya disease complicating intracranial aneurysms and to investigate the therapeutic strategy for moyamoya disease complicating intracranial aneurysms. Methods A total of 27 patients （28 aneurysms） with moyamoya disease complicating intracranial aneurysms confirmed by cerebral angiography were recruited. Nineteen patients were presented as hemorrhagic disease and 8 patients were presented as cerebral isehemic disease. For 10 patients with arterial trunk aneurysms, they were treated with endovascular embolization, and then were treated with unilateral EDAS 7-10 days after embolization. Three months later the contralateral EDAS were performed. As for the aneurysms located in the peripheral arteries （ n = 17 ） , if the embolization could be performed （ n = 9 ） , the aneurysms were obliterated with coils or ONYX glue, otherwise the ipsilateral EDAS should be performed （n = 8 ）. Results ①Eighteen aneurysms in 19 patients （20 aneurysms） were embolized suc- cessfully and 2 patients were failed （one aneurysm in ]enticulostriate artery and the other in posterior ehoroi-dal artery）. After embolization, 3 patients with peripheral aneurysms had contralateral limb weakness, and recovered within 1 week to 3 months. ②There was no bleeding and rebleeding for 10 -60 months follow-up after EDAS. Among the patients with cerebral ischemia, 2 had recurrence of TIA within 3 months after EDAS, but they had no recurrence of the symptom after 3 months.③The angiography of 21 patients （21 aneurysms） 3 to 15 months after EDAS showed that the aneurysms treated with embolization did not reoccur （12 aneurysms） ; 8 of 9 peripheral aneurysms without embolization were disappeared; and significant retention of contrast agent in 1 aneurysm was found. All 21 patients showed better communication between the superficial temporal artery and intracr