Nuerlanbieke Hanati, Niyazi Ailiyaer, Wu Qinfen, Yuan Yang, Habudele Zanghaer, Dun Xiaoyi, Wei RuRui, Aisha Abudula
Department of Neurosurgery, The 2th Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
Xinjiang Key Laboratory of Neurological Disorder Research, Urumqi, China.
Front Surg. 2023 Mar 29;10:1087311. doi: 10.3389/fsurg.2023.1087311. eCollection 2023.
To investigate the potential therapeutic benefits of Modified EDAS combined with superficial temporal fascia attachment-dural reversal surgery for the treatment of ischemic cerebrovascular disease.
Retrospective analysis was made on the clinical data of 33 patients with ischemic cerebrovascular disease, who were admitted to the Neurological Diagnosis and Treatment Center of the Second Affiliated Hospital of Xinjiang Medical University from December 2019 to June 2021. All patients were treated with Modified EDAS combined with superficial temporal fascia attachment-dural reversal surgery. At 3 months after operation, the outpatient department rechecked the patient's head CT perfusion imaging (CTP) to understand the intracranial cerebral blood flow perfusion. The DSA of the patient's head was re-examined 6 months after operation to observe the establishment of collateral circulation. The improved Rankin Rating Scale (mRS) score was used to evaluate the good prognosis rate of patients at 6 months after surgery. The mRS score ≤2 was defined as good prognosis.
The preoperative cerebral blood flow (CBF), local blood flow peak time (rTTP), and local mean transit time (rMTT) of 33 patients were 28.235 ml/(100 g·min), 17.702 s, 9.796 s, respectively. At 3 months after surgery, CBF, rTTP, and rMTT were 33.743 ml/(100 g·min), 15.688, and 8.100 s, respectively, with significant differences (< 0.05). At 6 months after operation, the establishment of extracranial and extracranial collateral circulation was observed in all patients by re-examination of head DSA. At 6 months after operation, the good prognosis rate was 81.8%.
The Modified EDAS combined with superficial temporal fascia attachment-dural reversal surgery is safe and effective in the treatment of ischemic cerebrovascular disease, which can significantly increase the establishment of collateral circulation in the operation area and improve the prognosis of patients.
探讨改良脑-硬脑膜动脉颞肌贴附术联合颞浅筋膜贴附-硬脑膜翻转术治疗缺血性脑血管病的潜在治疗效果。
回顾性分析2019年12月至2021年6月在新疆医科大学第二附属医院神经诊疗中心收治的33例缺血性脑血管病患者的临床资料。所有患者均接受改良脑-硬脑膜动脉颞肌贴附术联合颞浅筋膜贴附-硬脑膜翻转术治疗。术后3个月门诊复查患者头部CT灌注成像(CTP),了解颅内脑血流灌注情况。术后6个月复查患者头部DSA,观察侧支循环建立情况。采用改良Rankin量表(mRS)评分评估患者术后6个月的良好预后率。mRS评分≤2分为良好预后。
33例患者术前脑血流量(CBF)、局部血流达峰时间(rTTP)、局部平均通过时间(rMTT)分别为28.235 ml/(100 g·min)、17.702 s、9.796 s。术后3个月,CBF、rTTP、rMTT分别为33.743 ml/(100 g·min)、15.688、8.100 s,差异有统计学意义(<0.05)。术后6个月复查头部DSA,所有患者均观察到颅内外侧支循环建立。术后6个月,良好预后率为81.8%。
改良脑-硬脑膜动脉颞肌贴附术联合颞浅筋膜贴附-硬脑膜翻转术治疗缺血性脑血管病安全有效,可显著增加手术区域侧支循环建立,改善患者预后。