頭蓋内外血管吻合後の脳血管反応性 : イヌ脳底動脈,舌動脈-脳底動脈吻合系による検討

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Anastomosis between the extracranial artery and the cerebral artery is now an important reconstructive procedure for cerebrovascular occlusive disease. However, there are still some problems which remain unsolved in the hemodynamics of the anastomotic system. Since the external carotid artery and the cere brat vessels normally possess opposite reactivities to carbon dioxide and other drugs, it is necessary, in EC-IC anastomosis, to ascertain the reactivity of the anastomozed system. In this study, chemical control of the Jingo-basilar anastomotic system was investigated in dogs. Blood flow in the basilar and lingual arteries was measured by an electromagnetic flowmeter. The lingual artery was anastomosed end to side to the basilar artery which had been clipped at its origin. Blood flow of this anastomotic system was also measured electromagnetically. (a) Flow in the basilar artery: Following 7% CO_2 inhalation, blood flow increased by almost 100%. Intravenous administration of epinephrine and norepinephrine (2 μg/kg) produced a rapid increase in blood flow to 77% and 71% respectively, associated with a marked rise in systemic blood pressure. Intravenous injection of papaverine (2 mg/kg) increased blood flow (136%) despite of a slight fall in BP. The effect of apnea and resumption of respiration on blood flow showed a biphasic change. Acute hypertension was induced by inflation of a balloon which had been inserted into the aorta. Blood flow increased temporarily, but returned rapidly to its resting level. Autoregulation was well maintained. (b) Flow in the lingual artery: Seven percent CO_2 inhalation produced a reduction of blood flow (25%). After injection of epinephrine and norepinephrine, the flow was decreased 55% and 48% respectively despite a marked rise in BP. Papaverine produced an increase in blood flow (143%). (c) Flow in the lingo-basilar anastomotic system: Alterations in blood flow following the above-mentioned procedures were well correlated with the changes in the basilar arterial flow. Thus, it may be concluded that the lingo-basilar anastomotic system is chemically controlled through responses of the cerebral vessels and not of the external carotid system.
日本脳神経外科学会の論文
1981-08-15

頭蓋内外血管吻合後の脳血管反応性 : イヌ脳底動脈,舌動脈-脳底動脈吻合系による検討

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