One stage STA-MCA anastomosis for patients with SAH and occlusive ICA/MCA disease.
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概要
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We carried out one-stage superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis to prevent symptomatic vasospasm during aneurysmal clipping in 2 of 5 patients with significant occlusive lesions in the carotid system. Due to well-developed collateral circulation via the circle of Willis, 2 patients with occlusion of the common/internal carotid artery did not underg one-stages STA-MCA anastomosis. They did not suffer symptomatic vasospasm, although SPECT studies revealed mild hypoperfusion in the ipsilateral hemispheres at the acute stage. Of 3 patients with severe stenosis of the middle cerebral artery (MCA), 2 underwent one-stage STA-MCA aanastomosis, and did not suffer symptomatic vasospasm. However, symptomatic vasospasm caused severe consciousness disturbance and left hemiparesis in the one patient with severe MCA stenosis who did not undergo one-stage bypass surgery. In conclusion, one-stage STA-MCA anastomosis could prevent symptomatic vasospasm in certain groups of patients with subarachnoid hemorrhage and significant occlusive disease in the carotid system.
- 一般社団法人 日本脳卒中学会の論文
一般社団法人 日本脳卒中学会 | 論文
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