Bole P V, Babu S, Clauss R H
Surgery. 1978 Apr;83(4):440-4.
Cerebral revascularization, using extra-anatomic bypass grafts of autologous saphenous vein, was performed in three patients to prevent or to compensate for ischemic effects of emergency ligation of a carotid artery. These ligations were required after spontaneous disruption of common carotid arteries in patients with previous irradiation and radical head and neck surgery. External-carotid-to-external-carotid cross-over (submandibular) bypass graft was performed once, and ipsilateral axillointernal carotid bypass grafts twice. The role of infection in carotid artery rupture, the unpredictable nature and different mechanisms of cerebral malfunctions after carotid ligation, technical details of extra-anatomic bypass grafts, and anatomic considerations in the prevention of recurrent infection and bleeding are discussed. A planned approach of cerebral revascularization at the time of ligation appears to be preferable to a fortuitous outcome. Neurological disability and death from cerebral ischemia can be prevented by using extraanatomic bypass vein grafts.
对三名患者进行了脑血运重建术，采用自体大隐静脉的解剖外搭桥移植，以预防或补偿颈动脉紧急结扎的缺血效应。这些结扎是在先前接受过放疗和根治性头颈手术的患者出现颈总动脉自发性破裂后进行的。进行了一次颈外动脉到颈外动脉交叉（下颌下）搭桥移植，两次同侧腋-颈内动脉搭桥移植。讨论了感染在颈动脉破裂中的作用、颈动脉结扎后脑功能障碍的不可预测性和不同机制、解剖外搭桥移植的技术细节，以及预防复发性感染和出血的解剖学考虑因素。结扎时采用计划性脑血运重建方法似乎比偶然结果更可取。使用解剖外搭桥静脉移植可预防脑缺血导致的神经功能障碍和死亡。
