中国卒中杂志2024，Vol.19Issue(7)：762-768,7.DOI:10.3969/j.issn.1673-5765.2024.07.005
受体动脉不同临时阻断策略在烟雾病颞浅动脉-大脑中动脉搭桥术中的应用比较
Comparison of Different Temporary Occlusion Strategies for Recipient Arteries in the Application of Superficial Temporal Artery-Middle Cerebral Artery Bypass for Moyamoya Disease
陈方舟 1冯文峰 1漆松涛 1王刚 1龙廷翰 1陈俊达 1温运宇 1陈思源 1张国忠 1李明洲 1张世超 1康慧斌1
作者信息
- 1. 广州 510515 南方医科大学南方医院神经外科
- 折叠
摘要
Abstract
Objective To investigate the effects and reliability of different temporary occlusion techniques in end-to-side anastomosis of the superficial temporal artery-middle cerebral artery.
Methods A retrospective analysis was conducted on the data of patients with Moyamoya disease who underwent direct bypass surgery in the Department of Neurosurgery,Nanfang Hospital,Southern Medical University,from January 2015 to April 2023.The patients were divided into three groups according to the different temporary occlusion strategies:①multi-clips+rubber pad group(M+R group);②multi-clips group(M group);and ③single-clip group(S group).Temporary occlusion time,presence of errhysis after recipient artery incision,intraoperative perforator vessel injury,and postoperative novel cerebral infarction were compared among the three groups.
Results A total of 355 patients and 360 cerebral hemispheres were included in the analysis,and 360 patients were counted according to the number of cerebral hemispheres,including 188 males and 172 females,with an average age of(43.8±0.7)years.There were 45 cases in the M+R group,191 cases in the M group,and 124 cases in the S group.The average occlusion time were(37.9±9.8)minutes in the M+R group,(20.9±9.0)minutes in the M group,and(11.0±3.5)minutes in the S group,with significant differences between the groups(P＜0.001).The incidence of intraluminal errhysis of the recipient artery after occlusion and intraoperative perforator vessel injury was 8.89％in the M+R group(4 cases of recipient artery errhysis after occlusion),14.66％in the M group(19 cases of recipient artery errhysis after occlusion,8 cases of intraoperative perforator vessel injury,and 1 case of thrombosis at the temporary occlusion site),and 5.65％in the S group(7 cases of recipient artery errhysis after occlusion),with no significant difference between the groups(P＞0.05).There was no significant difference in the incidence of novel cerebral infarctions postoperatively(P＞0.05).
Conclusions The single-clip occlusion strategy is safe and effective,which significantly shortens the temporary occlusion time,and should be prioritized as the temporary occlusion technique in end-to-side anastomosis of the superficial temporal artery-middle cerebral artery.关键词
烟雾病/颞浅动脉-大脑中动脉/端侧吻合/临时阻断策略Key words
Moyamoya disease/Superficial temporal artery-middle cerebral artery/End-to-side anastomosis/Temporary occlusion strategy分类
医药卫生引用本文复制引用
陈方舟,冯文峰,漆松涛,王刚,龙廷翰,陈俊达,温运宇,陈思源,张国忠,李明洲,张世超,康慧斌..受体动脉不同临时阻断策略在烟雾病颞浅动脉-大脑中动脉搭桥术中的应用比较[J].中国卒中杂志,2024,19(7):762-768,7.
