증후성 내경동맥폐색 환자에서 두개내-외우회로형성술 후 혈관반응성의 회복
Restoration of Vasoreactivity in Patients with Symptomatic ICA Occlusion after Extracranial-Intracranial Bypass Surgery
대한뇌혈관학회지 2002년 4권 2호 p.135 ~ 139
강성돈, 박종태, 문성근,
소속 상세정보
강성돈 ( Kang Sung-Don )
원광대학교 의과대학 신경외과학교실
박종태 ( Park Jong-Tae )
원광대학교 의과대학 신경외과학교실
문성근 ( Moon Seong-Keun )
원광대학교 의과대학 신경외과학교실
KMID : 0890520020040020135
Abstract
Objective:The purpose of this study is to investigate changes of vasoreactivity after STA-MCA anastomosis in patients who develop hemodynamic cerebral ischemia associated with ICA or MCA occlusion.
Methods: Twenty-five patients with hemodyamic infarction due to symptomatic ICA or MCA occlusion were treated with extracranial-intracranial bypass surgery (EIAB). Of these, we enrolled 17 patients who underwent follow-up SPECT and follow-up angiogram. To test vasomotor reactivity, we measured relative regional cerebral blood flow (rrCBF) with SPECT both at rest and after diamox infusion. rrCBF were calculated using the following equation：(lesional radioactivity/contralateral radioactivity) ×100. We performed EIAB in patients with impaired vasomotor reactivity. To evaluate changes in vasomotor reactivity after surgery, follow-up brain SPECT was performed 1-6 months after surgery and compared rrCBF before and after surgery.
Results: Base line radioactivity ratios did not change after surgery. These ratios after diamox challenge were 59.8±4.2%, however, 1-6 months after surgery, ratios increased to 77.7±4.6% (p<0.05, Paired T-test). Preoperative degree of angiographic collateral circulation did not influence the restoration of vasoreactivity. All but two patients showed good collateral circulation through the bypass. There were no cerebral accidents in any these patients at 6 months to 2 years follow-up.
Conclusions: These results demonstrate the restoration of vasomotor reactivity distal to the occluded ICA or MCA after EIAB, and also show that measurement of rrCBF using SPECT are useful indicators of the clinical and hemodynamic improvement.
키워드
증후성 내경동맥폐색;두개내-외우회로형성술;혈관반응성
ICA or MCA occlusion;STA-MCA anastomosis;Vasoreactivity
원문 및 링크아웃 정보
등재저널 정보