Fischer G
Neurochirurgische Klinik, Universitätsklinikum des Saarlandes, Kirrberger Str. 90.5, 66421, Homburg/Saar, Deutschland.
Radiologie (Heidelb). 2024 Sep;64(9):719-723. doi: 10.1007/s00117-024-01343-8. Epub 2024 Jul 15.
There are barely any alternative treatment options to the drug treatment of hemodynamically caused cerebral ischemia, as in occlusion of the internal carotid artery.
For secondary prevention of an ischemic stroke due to carotid occlusion and hemodynamic instability, extracranial-intracranial (EC-IC) bypass surgery can be an important option in selected patients.
The development, study situation, indications and surgical technique for placement of an EC-IC bypass in cases of occlusion of the internal carotid artery are presented.
With appropriate expertise and strict selection of patients, the placement of an EC-IC bypass enables stabilization of cerebral perfusion with a low rate of complications.
The study situation is controversially discussed; nevertheless, surgical treatment in a specialized neurovascular center should at least be considered.
对于血流动力学导致的脑缺血,如颈内动脉闭塞,几乎没有药物治疗以外的替代治疗选择。
对于因颈动脉闭塞和血流动力学不稳定导致的缺血性卒中的二级预防,颅外-颅内(EC-IC)旁路手术对于部分患者可能是一种重要选择。
介绍了颈内动脉闭塞时EC-IC旁路手术的发展、研究现状、适应证及手术技术。
具备适当的专业技能并严格选择患者,进行EC-IC旁路手术可稳定脑灌注且并发症发生率低。
对研究现状存在争议性讨论;然而,至少应考虑在专业的神经血管中心进行手术治疗。