Akay K M
Department of Neurosurgery, Gülhane Military Medical Academy, Ankara, Turkey.
Minim Invasive Neurosurg. 2003 Feb;46(1):22-8. doi: 10.1055/s-2003-37965.
The problem of total therapeutic occlusion of the cranial arteries remains a relatively important area of concern for neurosurgery, neurology, neuroradiology and neuroanesthesia as well as for the patients. Cerebral revascularization procedures require total occlusion of the cranial arteries for a while. End-to-side anastomoses with partial lateral clipping were done in 20 cadaver arteries and then, in one rat common carotid artery. The results of the study were compared with the current cerebrovascular bypass procedures on a theoretical basis and possible clinical implications of the method were suggested. All the anastomoses were found to be open. As conclusions; 1) End-to-side anastomosis with partial lateral clipping and along with this technique the maintenance of blood flow in the target vessel during the anastomosis procedure are experimentally possible. 2) Although the available aneurysm clips may be used in the bigger vessels (> 2.5 mm), currently, the exclusive clips for the technique are not available commercially. 3) Further clinical implications of the technique may be investigated.
颅动脉完全治疗性闭塞问题仍然是神经外科、神经病学、神经放射学、神经麻醉学以及患者较为关注的一个重要领域。脑血运重建手术需要暂时完全闭塞颅动脉。在20条尸体动脉以及随后在1只大鼠的颈总动脉上进行了部分侧方夹闭的端侧吻合术。在理论基础上,将该研究结果与当前的脑血管搭桥手术进行了比较,并提出了该方法可能的临床意义。所有吻合口均通畅。结论如下:1)通过部分侧方夹闭进行端侧吻合,并且在此技术下在吻合过程中维持目标血管内的血流在实验上是可行的。2)尽管现有的动脉瘤夹可用于较大血管(>2.5毫米),但目前该技术专用的夹子尚无商业供应。3)该技术的进一步临床意义有待研究。