Chen Chuan, Ye Zhuopeng, Luo Lun, Guo Yuefei, Chang Yanyu, Ning Xinjie, Wang Hui
Department of Neurosurgery, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Department of Radiology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
World Neurosurg. 2018 Mar;111:e286-e293. doi: 10.1016/j.wneu.2017.12.060. Epub 2017 Dec 18.
To investigate the effect of carotid-carotid artery crossover bypass with a synthetic vascular graft for symptomatic type 1A common carotid artery occlusion (CCAO).
A retrospective analysis was conducted of patients with symptomatic type 1A CCAO who underwent carotid-carotid artery crossover bypass surgery via a retropharyngeal route with a synthetic vascular graft in the Department of Neurosurgery at our hospital. Preoperative demographic data, surgical complications, incidence of stroke during follow-up, and other clinical data were summarized.
Between 2011 and 2016, carotid-carotid artery crossover bypass was performed with a synthetic vascular graft in 4 patients with type 1A CCAO. The mean patient age was 63.3 years (range, 49-69 years). Clinical symptoms included dizziness, amaurosis fugax, persistent limb numbness, and transient ischemic attack. In all 4 patients, postoperative computed tomography angiography showed internal carotid artery thickening due to successful bypass, whereas computed tomography perfusion showed improved postoperative cerebral perfusion on the side of the lesion. The sole perioperative complication was a complaint of foreign body sensation on swallowing in 1 patient. The mean duration of follow-up was 40.3 months (range, 14-77 months), during which no newly occurred cerebral ischemia or synthetic vascular graft occlusion was observed.
Carotid-carotid artery crossover bypass with a synthetic vascular graft is a safe and effective therapeutic approach for patients with symptomatic type 1A CCAO. However, studies with larger series are needed to enable more precise conclusions.
探讨采用人工血管行颈-颈动脉交叉搭桥术治疗有症状的1A型颈总动脉闭塞（CCAO）的效果。
对我院神经外科采用人工血管经咽后途径行颈-颈动脉交叉搭桥术治疗有症状的1A型CCAO患者进行回顾性分析。总结术前人口统计学数据、手术并发症、随访期间卒中发生率及其他临床资料。
2011年至2016年，4例1A型CCAO患者采用人工血管行颈-颈动脉交叉搭桥术。患者平均年龄63.3岁（范围49 - 69岁）。临床症状包括头晕、一过性黑矇、持续性肢体麻木和短暂性脑缺血发作。所有4例患者术后计算机断层扫描血管造影显示搭桥成功导致颈内动脉增粗，而计算机断层扫描灌注显示病变侧术后脑灌注改善。围手术期唯一的并发症是1例患者出现吞咽时有异物感的主诉。平均随访时间为40.3个月（范围14 - 77个月），在此期间未观察到新发生的脑缺血或人工血管闭塞。
采用人工血管行颈-颈动脉交叉搭桥术治疗有症状的1A型CCAO患者是一种安全有效的治疗方法。然而，需要更多病例系列研究以得出更精确的结论。
