Hopkins L N, Grand W
Neurosurgery. 1979 Jul;5(1 Pt 1):21-31. doi: 10.1227/00006123-197907010-00004.
Eleven patients with lesions of the internal carotid and middle cerebral arteries that could not be treated by direct approach are presented. Major vessel occlusion was chosen as definitive therapy. Prophylactic extracranial-intracranial bypass was employed in an attempt to reduce the incidence of ischemic complications. Emphasis is placed on complications, from which several important lessons were learned. Our best results occurred in patients with carotid artery lesions treated with bypass and immediate internal carotid ligation. We believe this to be an effective and safe mode of therapy in cases in which direct approach is not feasible. The low risk and high potential benefit of prophylactic bypass justifies its use before major vessel occlusion in selected cases.
本文介绍了11例无法通过直接入路治疗的颈内动脉和大脑中动脉病变患者。选择主要血管闭塞作为确定性治疗方法。采用预防性颅外-颅内旁路手术，试图降低缺血性并发症的发生率。重点关注并发症，并从中吸取了几个重要教训。我们最好的结果出现在接受旁路手术并立即结扎颈内动脉的颈动脉病变患者中。我们认为，在直接入路不可行的情况下，这是一种有效且安全的治疗方式。预防性旁路手术的低风险和高潜在益处证明了在某些选定病例中，在主要血管闭塞之前使用它是合理的。
