Taguchi J, Yamada K, Miyamoto Y, Ito M, Kohmura E, Hayakawa T
Department of Neurosurgery, Osaka University Medical School, Japan.
Surg Neurol. 1992 Apr;37(4):300-6. doi: 10.1016/0090-3019(92)90157-i.
In seven patients with Takayasu arteritis, symptomatic cerebral ischemia was successfully treated by extracranial bypass surgery. We performed 14 surgical procedures, which included aortocarotid bypass, axilloaxillary bypass, carotid-vertebral bypass, subclavian-carotid bypass, axillocarotid bypass, carotid-carotid bypass, carotid-subclavian bypass, carotid-axillary bypass, and thyreocervical-carotid anastomosis. Among those the aortocarotid bypass was the most common procedure performed--six occasions in four cases. The others were less common procedures, each performed only one time. The saphenous vein was used for the graft in 12 of the procedures. An artificial graft made of Gore-Tex (6-mm inner diameter) was utilized in two cases. Patency of the grafts was adequate and no mortality or serious postoperative complication was encountered. Asymptomatic infarction developed in one patient. We analyze these procedures in detail and stress the usefulness of aortocarotid bypass with a saphenous vein graft.
在7例大动脉炎患者中，症状性脑缺血通过颅外搭桥手术成功治疗。我们进行了14次外科手术，包括主动脉颈动脉搭桥、腋腋搭桥、颈动脉椎动脉搭桥、锁骨下动脉颈动脉搭桥、腋颈动脉搭桥、颈动脉颈动脉搭桥、颈动脉锁骨下动脉搭桥、颈动脉腋动脉搭桥以及甲状腺颈总动脉吻合术。其中，主动脉颈动脉搭桥是最常进行的手术——4例患者共进行了6次。其他手术则较少见，每种仅进行了1次。14次手术中有12次使用大隐静脉作为移植血管。2例使用了聚四氟乙烯（内径6毫米）人工血管。移植血管通畅良好，未出现死亡或严重术后并发症。1例患者出现无症状性梗死。我们详细分析了这些手术，并强调了大隐静脉移植主动脉颈动脉搭桥术的有效性。
