高安動脈炎における脳血行再建術後合併症についての検討

概要

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As Takayasu arteritis is a systemic disease with considerable operative risks, strict surgical indication and adequate measures against possible postoperative complications are mandatory. Seventeen patients with Takayasu arteritis (3 males and 14 females aged between 13 and 62) were treated since 1984 in our institute. Sixteen bypass surgeries with saphenous vein grafts were performed in 12 patients, 3 bypass surgeries with synthetic grafts were performed in 2 patients and PTA was carried out in 5 patients. Postoperative hyperperfusion syndrome was observed in 2 patients whose preoperative angiograms had shown the occlusions of the 4 aortic arch branches, and cerebral blood flow (CBF) analysis had revealed diffuse hypoperfusion. Surgical revascularization should be indicated for those patients who have a significant risk of hyperperfusion syndrome. Sudden cardiac arrest occurred in 2 patients after reconstructive surgery though preoperative examination in cardiac function could not detect any abnormalities. CBF study is very useful in the treatment of Takayasu arteritis to determine the liklihood of postoperative complications such as hyperperfusion syndrome. In the postoperative period of surgical revascularization, the incidence of unexpectable cardiac complications should be kept in mind.
一般社団法人日本脳卒中の外科学会の論文