虚血性脳血管障害に対するバイパス手術適応の判定:-Scoringの試み-

概要

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The selection of proper patients for EC-IC bypass surgery has still remained difficult. The authors have attempted a new approach to this problem, to determine indications of the operation according to a certain standard, that is, a scoring system. Twenty-nine patients with ischemic cerebrovascular disease (TIA: 3, RIND: 2, slowly progressive stroke: 2, completed stroke: 22) who underwent STA-MCA anastomosis were studied. In these patients, clinical, neuroradiological and operative factors were analysed. The clinical factors included age, medical risk factors, characteristics of the attack, interval between the last attack and operation. The neuroradiological factors were the conditions of major arteries, those of lenticulostriate arteries and the development of the collateral circulation which were studied angiographically, and CT findings. Points were given to each factor according to its grade. The total score of each patient was calculated and compared with the operative result. The averaged score for each of the operative results was as followed; Asymptomatic or Good (13 cases): +3.3(S.D.±.1.0), Fair (7 cases): -0.4(±1.3) and Unchanged (9 catet): -2.6(±0.9). This scoring system seems to be useful in determining practically the candidates for EC-IC bypass surgery, and in anticipating prospectively the operative results.
The Japanese Society on Surgery for Cerebral Strokeの論文