Ko Jun Kyeung, Lee Sang Weon, Lee Tae Hong, Choi Chang Hwa
Department of Neurosurgery, School of Medicine, Pusan National University, Busan, Korea.
J Korean Neurosurg Soc. 2009 Nov;46(5):488-91. doi: 10.3340/jkns.2009.46.5.488. Epub 2009 Nov 30.
A 31-year-old man presented with right hemiparesis, and magnetic resonance imaging revealed a small infarct at left basal ganglia. Digital subtraction angiography showed left cervical internal carotid artery (ICA) occlusion and severe stenosis of the ipsilateral external carotid artery (ECA) with collateral cerebral circulation fed by ECAs. Based on the results of a functional evaluation of cerebral blood flow, we performed preventive ECA angioplasty and stenting for advanced ECA stenosis to ensure sufficient blood flow to the superficial temporal artery. Eight weeks later, superficial temporal artery to middle cerebral artery (STA-MCA) anastomosis was performed. His postoperative course was uneventful and no additional transient ischemic attacks have occurred. To our knowledge, this is the first report of preventive angioplasty and stenting for advanced narrowing of an ECA before STA-MCA anastomosis for ipsilateral ICA occlusion.
一名31岁男性出现右侧偏瘫，磁共振成像显示左侧基底节有一个小梗死灶。数字减影血管造影显示左侧颈内动脉（ICA）闭塞，同侧颈外动脉（ECA）严重狭窄，有来自颈外动脉的脑侧支循环。基于脑血流功能评估结果，我们对严重的颈外动脉狭窄进行了预防性颈外动脉血管成形术和支架置入术，以确保颞浅动脉有足够的血流。八周后，进行了颞浅动脉-大脑中动脉（STA-MCA）吻合术。他的术后病程平稳，未再发生额外的短暂性脑缺血发作。据我们所知，这是首例在同侧颈内动脉闭塞的STA-MCA吻合术前对颈外动脉严重狭窄进行预防性血管成形术和支架置入术的报告。
