Sakaki T, Kikuchi H, Furuse S, Karasawa J, Yoshida T
No Shinkei Geka. 1977 Mar;5(3):253-9.
Huge aneurysm taking place within the cavernous sinus or at the junction of the internal carotid artery with the ophthalmic artery must be treated by intra- and extracranial ligation of the internal carotid artery because of its anatomical specificity, if it is to be radically treated. Carotid-cavernous fistula which cannot be cured by embolization must also be treated by ligation of the internal carotid artery. However, if there is only a poor collateral circulation over the area distal to ligated portion, the operation surely incurs severe neurological deficit, so that trapping must be abandoned in such cases. Nevertheless, by establishing a bypass through anastomosis between the superficial temporal artery and the middle cerebral artery, the operation can be done safely. Further, even in cases of aneurysm taking place on the cerebral main vessel in which the aneurysm must be extirpated despite the presence of an important branch shooting-off from the aneurysm, or in some other cases (sphenoidal ridge meningioma, for instance) in which total extirpation of the tumor must necessarily be associated with sacrifice of the main vessel because it is involved in the brain tumor, we think that the operation can be performed rather safely through anastomosis with the vessel to be sacrificed. Some representative examples of such cases are described, and the usefulness of anastomosis between the superficial temporal artery and the middle cerebral artery in trapping of vascular disorders.
由于其解剖学特殊性，对于发生在海绵窦内或颈内动脉与眼动脉交界处的巨大动脉瘤，若要进行根治性治疗，必须通过颅内和颅外结扎颈内动脉。对于无法通过栓塞治愈的颈内动脉海绵窦瘘，也必须通过结扎颈内动脉进行治疗。然而，如果结扎部位远端区域的侧支循环较差，手术肯定会导致严重的神经功能缺损，因此在这种情况下必须放弃血管夹闭术。不过，通过在颞浅动脉和大脑中动脉之间进行吻合建立旁路，手术可以安全进行。此外，即使在大脑主要血管上发生动脉瘤的情况下，尽管动脉瘤有重要分支发出，但仍必须切除动脉瘤；或者在其他一些情况下（例如蝶骨嵴脑膜瘤），由于肿瘤累及主要血管，必须切除肿瘤就必然要牺牲主要血管，我们认为通过与要牺牲的血管进行吻合，手术可以相当安全地进行。文中描述了此类病例的一些典型例子，以及颞浅动脉与大脑中动脉吻合在治疗血管疾病中的作用。
