Carotide-Carotid Artery Crossover Bypass with a Synthetic Vascular Graft for Symptomatic Type 1A Common Carotid Artery Occlusion
Carotide-Carotid Artery Crossover Bypass with a Synthetic Vascular Graft for Symptomatic Type 1A Common Carotid Artery Occlusion
复制标题
使用合成血管移植物进行颈动脉-颈动脉交叉搭桥术治疗有症状的 1A 型颈总动脉闭塞
DOI：
10.1016/j.wneu.2017.12.060
复制
发表时间：
2018
影响因子：
2
通讯作者：
Wang Hui
中科院分区：
文献类型：
--
作者：
Chen Chuan;Ye Zhuopeng;Luo Lun;Guo Yuefei;Chang Yanyu;Ning Xinjie;Wang Hui
目的探讨颈动脉-颈动脉交叉旁路移植术治疗1A型症状性颈总动脉闭塞（CCAO）的疗效。方法回顾性分析我院神经外科1A型症状性CCAO患者行颈动脉-颈动脉交叉旁路移植术的临床资料。术前人口统计学数据，手术并发症，中风的发生率在随访期间，和其他临床data.ResultsBetween 2011年和2016年，颈动脉-颈动脉交叉旁路术进行了合成血管移植物在4例1A型CCAO。患者平均年龄为63.3岁（范围：49-69岁）。临床症状包括头晕、一过性黑蒙、持续性肢体麻木和短暂性脑缺血发作。在所有4例患者中，术后计算机断层扫描血管造影显示由于成功的旁路手术导致颈内动脉增厚，而计算机断层扫描灌注显示病变侧的术后脑灌注改善。唯一的围手术期并发症是1例患者吞咽异物感的投诉。平均随访时间为40.3个月（范围，14-77个月），在此期间，没有新发生的脑缺血或合成血管移植物闭塞observed.ConclusionsCarotid-carotid动脉交叉旁路术与合成血管移植物是一种安全有效的治疗方法，为患者有症状的1A型CCAO。然而，需要更大系列的研究才能得出更准确的结论。
ObjectiveTo investigate the effect of carotid–carotid artery crossover bypass with a synthetic vascular graft for symptomatic type 1A common carotid artery occlusion (CCAO).MethodsA retrospective analysis was conducted of patients with symptomatic type 1A CCAO who underwent carotid–carotid artery crossover bypass surgery via a retropharyngeal route with a synthetic vascular graft in the Department of Neurosurgery at our hospital. Preoperative demographic data, surgical complications, incidence of stroke during follow-up, and other clinical data were summarized.ResultsBetween 2011 and 2016, carotid–carotid artery crossover bypass was performed with a synthetic vascular graft in 4 patients with type 1A CCAO. The mean patient age was 63.3 years (range, 49–69 years). Clinical symptoms included dizziness, amaurosis fugax, persistent limb numbness, and transient ischemic attack. In all 4 patients, postoperative computed tomography angiography showed internal carotid artery thickening due to successful bypass, whereas computed tomography perfusion showed improved postoperative cerebral perfusion on the side of the lesion. The sole perioperative complication was a complaint of foreign body sensation on swallowing in 1 patient. The mean duration of follow-up was 40.3 months (range, 14–77 months), during which no newly occurred cerebral ischemia or synthetic vascular graft occlusion was observed.ConclusionsCarotid–carotid artery crossover bypass with a synthetic vascular graft is a safe and effective therapeutic approach for patients with symptomatic type 1A CCAO. However, studies with larger series are needed to enable more precise conclusions.