Morgan M, Besser M, Dorsch N, Segelov J
Surg Neurol. 1986 Jul;26(1):85-91. doi: 10.1016/0090-3019(86)90069-8.
Seven patients with internal carotid artery aneurysms, and one patient with a middle cerebral artery aneurysm, were managed by combining proximal ligation with an extracranial-intracranial bypass procedure. Five bypasses were done with an interposed vein graft between the external carotid artery and the distal middle cerebral artery (vein graft), and three were superficial temporal-middle cerebral artery bypasses (superficial temporal artery grafts). As demonstrated in postoperative angiograms, all eight patients had patent bypasses with nonfilling of the aneurysm. One patient developed transient dysphasia, but there were no permanent neurological deficits associated with carotid occlusion. Four patients had resolution of their neurological problems, and another three patients improved. The distribution of flow from vein grafts is more extensive than from superficial temporal artery grafts. This offers increased protection against ischemia, and increases the likelihood of internal carotid artery aneurysm thrombosis by reducing the turbulence in the distal internal carotid artery.
7例颈内动脉瘤患者和1例大脑中动脉瘤患者接受了近端结扎联合颅外-颅内搭桥手术治疗。5例采用颈外动脉与大脑中动脉远端之间置入静脉移植物进行搭桥（静脉移植物），3例为颞浅动脉-大脑中动脉搭桥（颞浅动脉移植物）。术后血管造影显示，所有8例患者的搭桥血管均通畅，动脉瘤未显影。1例患者出现短暂性失语，但未出现与颈动脉闭塞相关的永久性神经功能缺损。4例患者的神经问题得到解决，另外3例患者病情改善。静脉移植物的血流分布比颞浅动脉移植物更广泛。这提供了更强的缺血保护作用，并通过减少颈内动脉远端的血流紊乱增加了颈内动脉瘤血栓形成的可能性。
