Usachev D Yu, Lukshin V A, Shevchenko E V, Shmigel'skiy A V, Sosnin A D, Akhmedov A D
Burdenko Neurosurgical Institute, Moscow, Russia.
Zh Vopr Neirokhir Im N N Burdenko. 2017;81(5):76-83. doi: 10.17116/neiro201781576-83.
The article describes a case of one-stage surgical treatment of a patient with progressive chronic cerebral ischemia caused by combined steno-occlusive lesions of the carotid and vertebral arteries. The disease was complicated by intolerance to temporary occlusion of the carotid artery due to an incomplete circle of Willis. We performed extra-anatomic carotid-vertebral artery bypass with subsequent ipsilateral carotid endarterectomy. A temporary intraluminal shunt was used at the main stage of reconstructive surgery. We use this clinical case to analyze the issues of surgical treatment for combined lesions of the carotid and vertebral arteries and the techniques for prevention of associated ischemic complications.
本文描述了一例因颈动脉和椎动脉联合狭窄闭塞性病变导致进行性慢性脑缺血患者的一期手术治疗情况。该疾病因 Willis 环不完整而并发对颈动脉临时闭塞不耐受。我们进行了解剖外颈动脉 - 椎动脉搭桥术,随后进行同侧颈动脉内膜切除术。在重建手术的主要阶段使用了临时腔内分流器。我们利用这个临床病例来分析颈动脉和椎动脉联合病变的手术治疗问题以及预防相关缺血性并发症的技术。