Esposito Giuseppe, Sebök Martina, Fierstra Jorn, Regli Luca
Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Zurich Microsurgery Lab, Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland.
Acta Neurochir Suppl. 2025;136:113-118. doi: 10.1007/978-3-031-89844-0_14.
Flow-augmentation bypass aims to enhance blood flow to hypoperfused brain regions in patients with cerebrovascular steno-occlusive diseases. This surgical procedure is indicated for ischemic and hemorrhagic moyamoya vasculopathy and for selected patients with chronic steno-occlusive disease and acute ischemic stroke. Flow-augmentation bypass has been rigorously evaluated in randomized clinical trials, including the EC-IC Bypass Trial, the Carotid Occlusion Surgery Study (COSS), the Japanese Adult Moyamoya (JAM) trial, and the recent Carotid and Middle Cerebral Artery Occlusion Surgery Study (CMOSS). In this article, we examine the current indications and outline the diagnostic and therapeutic decision-making processes for patients with steno-occlusive disease who are candidates for flow-augmentation bypass surgery.
血流增加旁路手术旨在增加脑血管狭窄闭塞性疾病患者灌注不足脑区的血流。该手术适用于缺血性和出血性烟雾病，以及部分慢性狭窄闭塞性疾病和急性缺血性卒中患者。血流增加旁路手术已在随机临床试验中得到严格评估，包括颅外-颅内旁路试验、颈动脉闭塞手术研究（COSS）、日本成人烟雾病（JAM）试验以及最近的颈动脉和大脑中动脉闭塞手术研究（CMOSS）。在本文中，我们探讨了当前的适应证，并概述了适合血流增加旁路手术的狭窄闭塞性疾病患者的诊断和治疗决策过程。
