Klijn C J, Kappelle L J, van der Grond J, van Gijn J, Tulleken C A
University Department of Neurology, University Hospital Utrecht, The Netherlands.
Cerebrovasc Dis. 1998 May-Jun;8(3):184-7. doi: 10.1159/000015845.
Since the completion of the international extracranial/intracranial (EC/IC) bypass study in 1985, no treatment of proven value has become available for patients with symptomatic carotid artery occlusion other than treatment with antithrombotic medication. However, in this trial the causal factors of cerebral ischaemia were not part of the inclusion criteria and also patients with single episodes only were included. We report successful Excimer laser-assisted high flow EC/IC bypass surgery in a patient with frequent transient ischaemic attacks associated with a low flow state of the cerebral circulation. In the 1.5 years after the operation the patient has never again experienced any symptoms of cerebral ischaemia. In addition there was improvement in cerebral blood flow, measured by magnetic resonance spectroscopy and hexamethylpropyleneamine oxime single photon emission computed tomography. Certain patients with occlusion of the internal carotid artery may benefit from EC/IC bypass surgery, in particular the Excimer laser-assisted high-flow bypass, that is, if recurrent (transient) ischaemic attacks are associated with compromised cerebral perfusion.
自1985年国际颅外/颅内（EC/IC）搭桥研究完成以来，除了抗血栓药物治疗外，对于有症状的颈动脉闭塞患者，尚无经证实有价值的治疗方法。然而，在该试验中，脑缺血的病因并非纳入标准的一部分，且仅纳入了仅有单次发作的患者。我们报告了1例伴有脑循环低流量状态且频繁发生短暂性脑缺血发作的患者，成功接受了准分子激光辅助高流量EC/IC搭桥手术。术后1.5年内，该患者再也没有出现过任何脑缺血症状。此外，通过磁共振波谱和六甲基丙烯胺肟单光子发射计算机断层扫描测量，脑血流量有所改善。某些颈内动脉闭塞患者可能从EC/IC搭桥手术中获益，尤其是准分子激光辅助高流量搭桥手术，即如果复发性（短暂性）脑缺血发作与脑灌注受损相关。
