From the Department of Anesthesia and Perioperative Medicine, London Health Science Centre, University of Western Ontario, Toronto, Ontario, Canada; Department of Anesthesia, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada; and Division of Neurosurgery, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Anesth Analg. 2015 Jan;120(1):193-203. doi: 10.1213/ANE.0000000000000470.
Cerebral revascularization is used to augment or replace cerebral blood flow in patients at risk of developing cerebral ischemia. These include patients with moyamoya disease, occlusive cerebrovascular disease, skull base tumors, and complex aneurysms. Our aim in this review is to provide a comprehensive update of both surgical and anesthetic aspects of cerebral revascularization procedures. The anesthetic concerns for most patients presenting for different types of bypass procedures are similar and include the maintenance of adequate cerebral perfusion to prevent cerebral ischemia. Patients with complex aneurysms and tumors have additional considerations related to the surgical treatment of the underlying pathology.
脑血运重建术用于增加或替代有发生脑缺血风险的患者的脑血流。这些患者包括烟雾病、脑血管闭塞性疾病、颅底肿瘤和复杂动脉瘤患者。我们在本篇综述中的目的是提供脑血运重建术的手术和麻醉方面的全面更新。大多数接受不同类型旁路手术的患者的麻醉关注点相似,包括维持足够的脑灌注以防止脑缺血。复杂动脉瘤和肿瘤患者还有与基础病变的手术治疗相关的其他注意事项。