de Vries E J, Sekhar L N, Horton J A, Eibling D E, Janecka I P, Schramm V L, Yonas H
Department of Otolaryngology, University of Pittsburgh School of Medicine, PA.
Laryngoscope. 1990 Jan;100(1):85-8. doi: 10.1288/00005537-199001000-00017.
A patent internal carotid artery (ICA) is essential in most patients. Management of skull base lesions often requires translocation, balloon embolization, or resection of this vessel. Preoperative tests to assess the availability of collateral flow have not been uniformly accurate. A new test that significantly increases the safety of surgical removal of the ICA is described. One hundred thirty-six patients were studied with temporary balloon occlusion (TBO) of the ICA and determination of stable xenon-enhanced computed tomography cerebral blood flow (Xe/CT CBF) measurements. Eleven patients failed TBO and were determined to be at very high risk of stroke with loss of the ICA. Ninety-six of the patients were predicted to be at minimal risk with permanent loss of the ICA by Xe/CT CBF studies. Twenty-one patients in this group had either permanent balloon occlusion (PBO) or surgical resection of the ICA with no permanent neurologic sequelae. Our studies show that the combination of preoperative TBO and Xe/CT CBF studies significantly increases the safety of ICA resection.
大多数患者需要一条通畅的颈内动脉（ICA）。颅底病变的治疗通常需要对该血管进行移位、球囊栓塞或切除。术前评估侧支血流可用性的检查并不总是准确的。本文描述了一种能显著提高颈内动脉手术切除安全性的新检查方法。对136例患者进行了颈内动脉临时球囊闭塞（TBO）及稳定氙增强计算机断层扫描脑血流量（Xe/CT CBF）测量的研究。11例患者TBO失败，被判定为颈内动脉丧失后发生中风的风险极高。通过Xe/CT CBF研究，96例患者被预测为颈内动脉永久性丧失后风险极小。该组21例患者进行了永久性球囊闭塞（PBO）或颈内动脉手术切除，无永久性神经后遗症。我们的研究表明，术前TBO和Xe/CT CBF研究相结合可显著提高颈内动脉切除的安全性。
