浅側頭-中大脳動脈吻合術における経皮的超音波ドプラ血流計測の意義

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Hemodynamics in ST-MCA were investigated transcutaneously by bidirectional ultrasonic Doppler flowmeter with sound spectrograph on 20 bypasses of 17 patients, including 6 with "moyamoya" disease and one with internal carotid giant aneurysm. These bypasses were performed in 15 for occlusive lesions of the middle cerebral artery and/or the internal carotid artery on the side of ST-MCA and in 5 for stenotic lesions of them. Flow measurements were performed preoperatively and postoperatively in arteries being closely related with ST-MCA (common carotid arteries, internal carotid arteries, external carotid arteries, superficial temporal arteries, and ophthalmic arteries). Preoperative findings of Doppler flowmetry were in good agreement with those of preoperative angiography. In postoperative flow study, flow through the donor artery was poor or not detected in five ST-MCAs and four of them were in patients with "moyamoya" disease and one in patient with internal caritid stenotic lesion. In the remaining 15 good-functioning bypasses (75%), flow pattern of the superficial temporal artery, which was naturally the flow pattern of the external carotid artery, turned to that of the internal carotid artery. These results were also in good agreement with the findings of postoperative angiography. Relatively poor function in those with "moyamoya" disease accompanied with a relatively well developed collateral circulation and in those with stenotic lesions was ascribed to the low pressure gradient between the donor and recipient artery. Flow study by Doppler ultrasonic flowmeter with sound spectrograph was very useful not only to know the graft patency of ST-MCA but also to obtain various kinds of hemodynamic information on ST-MCA.
The Japanese Society on Surgery for Cerebral Strokeの論文

浅側頭-中大脳動脈吻合術における経皮的超音波ドプラ血流計測の意義

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