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颅外-颅内搭桥手术中受体动脉夹层：两例报告。

Recipient artery dissection during extracranial-intracranial bypass surgery: Two case reports.

作者信息

Lee Yong-Jun, Park Wan, Joo Sung-Pil

机构信息

Department of Neurosurgery, Chonnam National University Hospital and Medical School, Gwangju 61469, South Korea.

Department of Neurosurgery, Chonnam National University Hospital, Gwangju 61469, South Korea.

出版信息

World J Clin Cases. 2024 Nov 6;12(31):6479-6485. doi: 10.12998/wjcc.v12.i31.6479.

DOI:10.12998/wjcc.v12.i31.6479
PMID:39507111
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11438688/
Abstract

BACKGROUND

Superficial temporal artery to middle cerebral artery (STA-MCA) bypass is a valuable treatment for preventing ischemia and hemorrhage in occlusive cerebrovascular disease. Anastomosis site dissection is rarely reported among the various bypass-related complications.

CASE SUMMARY

In this case report, we describe two patients, who were 63- and 59-years-old with middle cerebral artery occlusion treated by STA-MCA bypass. During bypass surgery, the recipient M4 artery intima was dissected. We sacrificed the dissecting portion, and no complications occurred during the follow-up period. Postoperative brain imaging revealed improved brain perfusion. We report rare cases of recipient artery dissection located in the extracranial to intracranial bypass site, and we suggest atherosclerotic changes in the recipient artery and insufficient puncture as the causes.

CONCLUSION

Appropriate recipient artery selection is critical, and if dissection occurs, it is essential to sacrifice the dissecting portion quickly.

摘要

背景

颞浅动脉-大脑中动脉（STA-MCA）搭桥术是预防闭塞性脑血管疾病缺血和出血的一种有效治疗方法。在各种与搭桥相关的并发症中，吻合口部位的解剖分离很少被报道。

病例总结

在本病例报告中，我们描述了两名分别为63岁和59岁的大脑中动脉闭塞患者，他们接受了STA-MCA搭桥术治疗。在搭桥手术过程中，受体M4动脉内膜发生了解剖分离。我们舍弃了发生解剖分离的部分，在随访期间未出现并发症。术后脑部影像学检查显示脑灌注得到改善。我们报告了位于颅外至颅内搭桥部位的受体动脉解剖分离的罕见病例，并认为受体动脉的动脉粥样硬化改变和穿刺不足是其原因。

结论

选择合适的受体动脉至关重要，如果发生解剖分离，必须迅速舍弃发生解剖分离的部分。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3725/11438688/0ee7d62ed1ca/WJCC-12-6479-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3725/11438688/9046811a8df9/WJCC-12-6479-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3725/11438688/e22d3cef5c6d/WJCC-12-6479-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3725/11438688/c492c0a28ea4/WJCC-12-6479-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3725/11438688/0ee7d62ed1ca/WJCC-12-6479-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3725/11438688/9046811a8df9/WJCC-12-6479-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3725/11438688/e22d3cef5c6d/WJCC-12-6479-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3725/11438688/c492c0a28ea4/WJCC-12-6479-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3725/11438688/0ee7d62ed1ca/WJCC-12-6479-g004.jpg

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本文引用的文献

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J Neurosurg Case Lessons. 2024 Jan 22;7(4). doi: 10.3171/CASE23665.
2
Aneurysm appearing at the anastomosis site 11 years after superficial temporal artery-middle cerebral artery bypass surgery: moyamoya disease with a rapidly growing aneurysm. Illustrative case.颞浅动脉-大脑中动脉搭桥手术后11年吻合口处出现动脉瘤：烟雾病合并快速生长的动脉瘤。病例说明
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[Evidence of STA-MCA Bypass-History and Overseas Articles].
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Rapid Development of an Aneurysm at the Anastomotic Site of a Superficial Temporal Artery to Middle Cerebral Artery Bypass: Case Report and Literature Review.吻合口处的浅颞动脉到大脑中动脉旁路处动脉瘤的快速发展：病例报告及文献复习。
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