Critical fiowと血行再建術の適応

概要

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Critical level of cerebral blood flow was estimated from 40 selected patients with ischemic cerebrovascular diseases (embolisms excluded) in comparative study with regional cerebral blood flow (rCBF) and computed tomography (CT). Regional CBF was performed by 133Xe intracarotid injection method with 16 channel multidetectors, and the existence of low density area in cetrum semiovale was checked by CT scan. The results of extra-intracranial arterial anastomosis (EIAB) were also investigated in correlation to the rCBF study in 20 cases, based on the above study. Mean rCBFs were ranged 13-26 ml/100g/min. in 13 patients with low density area in centrum semiovale on CT, and were ranged 25-49ml/100g/min. in 27 patients without low density in the area on CT. From these data, critical flow level was estimated 25-26ml/100g/min. (40-42% of normal) of mean flow. In surgical group, the patients with preoperative mean rCBF between 25 and 30ml/100g/min. markedly improved after surgery. These two results suggest that the EIAB operation should be done for the patients with critical flow level of ischemia as low as 25-30ml/100g/min. of mean flow.
The Japanese Society on Surgery for Cerebral Strokeの論文