Usachev D Iu, Lukshin V A, Lubnin A Iu, Pronin I N, Shakhnovich V A, Shmigel'skiĭ A V, Ogurtsova A A, Churilov M V, Shishkina L V, Kiniakov V N
Zh Vopr Neirokhir Im N N Burdenko. 2007 Jan-Mar(1):16-22.
The study was conducted at the Academician N. N. Burdenko Institute of Neurosurgery, Moscow, in 1999 to 2006. The paper presents the results of stepwise surgical treatment in 84 patients with chronic cerebral ischemia, caused by multiple stenotic and occlusive lesions of the brachiocephalic arteries, who underwent 183 reparative operations. Six major groups of patients with various combinations of lesions of major cerebral arteries were identified. An attempt was made to create an algorithm of the optimum stepwise surgical treatment policy in the identified groups of patients on the basis of the site, degree, and nature of stenotic lesions, by taking into account the cerebral hemodynamics and collateral circulation at all stages of surgical treatment. At the same time, changes in the degree of neurological deficit as one of the major determinants of the results of surgical treatment could be evaluated. The study has demonstrated that the chosen tactics of employing series arterial reconstructions in multiple stenotic and occlusive lesions of major cerebral arteries is an effective treatment option in patients with chronic cerebral ischemia.
该研究于1999年至2006年在莫斯科的N. N. 布尔坚科院士神经外科研究所进行。本文介绍了84例因头臂动脉多发狭窄和闭塞性病变导致慢性脑缺血患者的逐步手术治疗结果，这些患者共接受了183次修复手术。确定了六组主要大脑动脉病变组合各异的患者。根据狭窄病变的部位、程度和性质，考虑手术治疗各阶段的脑血流动力学和侧支循环，尝试为已确定的患者群体制定最佳逐步手术治疗策略的算法。同时，可以评估神经功能缺损程度的变化，这是手术治疗结果的主要决定因素之一。该研究表明，在主要大脑动脉多发狭窄和闭塞性病变中采用系列动脉重建的选定策略是慢性脑缺血患者的一种有效治疗选择。
