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[颅内-外微吻合术治疗颈内动脉单侧闭塞的血流动力学疗效评估]

[An evaluation of the hemodynamic efficacy of an extra-intracranial microanastomosis in unilateral occlusion of the internal carotid artery].

作者信息

Kuperberg E B, Rudnev I N, Lavrent'ev A V, Iarustovskiĭ M B, Tutova M G, Gaĭdashev A E

出版信息

Zh Nevrol Psikhiatr Im S S Korsakova. 1994;94(2):16-20.

PMID:7941881
Abstract

The physicians of the A. N. Bakulev Institute for Cardiovascular Surgery examined 64 patients with unilateral atherosclerotic occlusion of the internal carotid artery (ICA). TCDG and angiography were employed before and after establishment of EICMA. TCDG proved highly informative in assessment of collateral circulation (sensitivity 95.6%). Indications to EICMA should be based on overall account of initial stage of cerebrovascular insufficiency and collateral circulation. EICMA is indicated for patients with compensated and relatively compensated cerebrovascular insufficiency (transient ischemic attacks, minor apoplexy, dyscirculatory encephalopathy), residue sequelae of ischemic apoplexy stroke, baseline poor collateral circulation. Differentiated approach to EICMA establishment allows improved outcomes of the surgery and revision of common among angio-neurosurgeons attitude to the above surgery in ICA occlusion.

摘要

A.N. 巴库列夫心血管外科研究所的医生对64例单侧颈内动脉(ICA)动脉粥样硬化闭塞患者进行了检查。在建立脑-颈血管搭桥术(EICMA)前后均采用了经颅多普勒血流动力学(TCDG)和血管造影术。TCDG在评估侧支循环方面显示出很高的信息量(敏感性95.6%)。EICMA的适应证应基于对脑血管供血不足初始阶段和侧支循环的全面评估。EICMA适用于代偿性和相对代偿性脑血管供血不足(短暂性脑缺血发作、轻度中风、循环障碍性脑病)、缺血性中风的残留后遗症、基线侧支循环不良的患者。对EICMA建立采用差异化方法可改善手术效果,并改变血管神经外科医生对ICA闭塞上述手术的普遍态度。

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