カワシマ　アキツグ   Akitsugu Kawashima   川島　明次    所属   医学部 医学科（東京女子医科大学病院）    職種   准教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	External carotid endarterectomy followed by superficial temporal artery to middle cerebral artery anastomosis for internal carotid artery occlusion with advanced ipsilateral external carotid stenosis.
掲載誌名	正式名：Neurosurgery 略　 称：Neurosurgery ISSNコード：15244040/0148396X
掲載区分	国外
巻・号・頁	62(5 Suppl 2),pp.ONS395-9; discussion ONS399
著者・共著者	Kawamata Takakazu, Okada Yoshikazu, Kawashima Akitsugu, Yamaguchi Kohji, Hori Tomokatsu
発行年月	2008/05
概要	OBJECTIVE:For patients with internal carotid artery occlusion with advanced narrowing of the ipsilateral external carotid artery (ECA), we performed preventive carotid endarterectomy (CEA) for the ECA stenosis before superficial temporal artery (STA) to middle cerebral artery (MCA) anastomosis for internal carotid artery occlusion.METHODS:Between August 2002 and July 2005, we treated seven patients with such lesions, six men and one woman, ranging in age from 52 to 66 years (median, 60 yr). Before STA-MCA anastomosis, we performed preventive CEA for advanced ECA stenosis (>70%) to ensure sufficient blood flow to the STA. STA-MCA double anastomoses were performed more than 1 month after the CEA. Postoperative cerebrovascular complications and carotid restenosis were investigated.RESULTS:All patients in the present series had an excellent postoperative course without cerebrovascular complications during either the CEA or STA-MCA anastomosis phase. Furthermore, no postoperative carotid restenosis occurred, and all STA-MCA anastomoses were patent during a mean follow-up period of 35.6 months.CONCLUSION:The present study suggests that surgical management by external CEA followed by STA-MCA anastomosis is safe and effective for patients with internal carotid artery occlusion and advanced stenosis of the ipsilateral ECA.
DOI	10.1227/01.neu.0000326024.93724.16
PMID	18596520