我是这样做的：保留胸锁乳突肌的方法，用于右椎动脉至颈总动脉转位。
How I do it: Sternocleidomastoid sparing approach for the right vertebral artery to common carotid artery transposition.
机构信息
Department of Neurosurgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan.
出版信息
Acta Neurochir (Wien). 2024 Jun 5;166(1):251. doi: 10.1007/s00701-024-06114-x.
BACKGROUND
Direct surgery is an important option to treat vertebral artery (VA) stenosis.
METHOD
A patient with symptomatic stenosis at the origin of the right VA underwent transposition of the right VA to the common carotid artery (CCA). Using the sternocleidomastoid sparing approach, the VA was anastomosed to the posterior wall of the CCA by twisting the CCA to expose its posterior wall to face the operative field.
CONCLUSION
This approach, consisting of securing the proximal VA and then following it to its distal end, not only preserves the sternocleidomastoid muscle but also protects the sympathetic chains and thoracic duct.
背景
直接手术是治疗椎动脉（VA）狭窄的重要选择。
方法
一名右侧 VA 起始处有症状性狭窄的患者接受了右侧 VA 向颈总动脉（CCA）的转位术。采用胸锁乳突肌保留入路，通过扭转 CCA 以暴露其后壁来面对手术区域，将 VA 吻合到 CCA 的后壁。
结论
这种方法包括固定近端 VA，然后跟随它到远端，不仅保留了胸锁乳突肌，还保护了交感神经链和胸导管。
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