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[颞浅动脉-大脑中动脉搭桥术的证据-历史与国外文献]

[Evidence of STA-MCA Bypass-History and Overseas Articles].

作者信息

Yoshida Kazumichi

机构信息

Department of Neurosurgery, Kyoto University Graduate School of Medicine.

出版信息

No Shinkei Geka. 2022 Jul;50(4):735-744. doi: 10.11477/mf.1436204615.

Abstract

The superficial temporal artery to middle cerebral artery(STA-MCA)bypass technique developed by M. Gazi Yaşargil and Raymond M. P. Donaghy in the 1960s was rapidly adopted throughout the world as a procedure for surgical flow augmentation for ischemic cerebrovascular disease(CVD). However, the effectiveness of STA-MCA bypass for atherosclerotic occlusive CVD has not been proven in the extracranial-intracranial(EC-IC)bypass and carotid occlusion surgery studies(COSS), both conducted in the United States. Subsequently, the number of STA-MCA bypasses performed for atherosclerotic CVD decreased globally. In contrast, the Japanese EC-IC Bypass Trial demonstrated the efficacy of STA-MCA bypass for occlusive CVD. The number of research articles reassessing bypass surgery with appropriate indications and high quality of care has recently increased, and carotid and middle cerebral artery occlusion surgery studies designed with careful consideration for several criticisms against COSS are now being conducted in China. This article reviews foreign papers related to STA-MCA bypass for atherosclerotic CVD and describes the current consensus regarding both surgical and medical treatment.

摘要

20世纪60年代由M. 加齐·亚萨吉尔(M. Gazi Yaşargil)和雷蒙德·M. P. 多纳吉(Raymond M. P. Donaghy)开发的颞浅动脉-大脑中动脉(STA-MCA)搭桥技术,作为一种增加缺血性脑血管疾病(CVD)手术血流量的方法,在全球迅速得到采用。然而,在美国进行的颅外-颅内(EC-IC)搭桥和颈动脉闭塞手术研究(COSS)中,尚未证实STA-MCA搭桥治疗动脉粥样硬化闭塞性CVD的有效性。随后,全球范围内因动脉粥样硬化性CVD而进行的STA-MCA搭桥手术数量减少。相比之下,日本的EC-IC搭桥试验证明了STA-MCA搭桥治疗闭塞性CVD的疗效。最近,重新评估具有适当适应症和高质量护理的搭桥手术的研究文章数量有所增加,并且中国正在进行一些针对COSS的若干批评进行仔细考虑而设计的颈动脉和大脑中动脉闭塞手术研究。本文回顾了国外有关STA-MCA搭桥治疗动脉粥样硬化性CVD的论文,并描述了目前关于手术和药物治疗的共识。

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