急性期の進行性脳梗塞に対するSTA-MCAバイパスに伴うリスク回避のための外科的対処の一方法 ─ジャンピング・バイパスについて
脳梗塞急性期における治療抵抗性の脳梗塞に対して，過灌流を予防しつつ灌流の不均等さを是正するための手術方式を紹介する．この手技は，1本の浅側頭動脈の途中を側側吻合とし先端部分を端側吻合とすることで，離れた領域に灌流を可能とするものである．提示する症例は79歳の進行性脳梗塞の患者で，浅側頭動脈近位部を側側吻合で側頭葉にバイパスし，次いで遠位部を端側吻合で前頭葉にバイパスした．この手術方法によって，症例は過灌流症状を呈することなく急速な症状改善を示した．この方法は，シングルバイパスでは灌流が不十分となる場合や，過灌流が予想されるような対象に対して有効な対処法かもしれない．...
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| Published in | 脳卒中の外科 Vol. 49; no. 6; pp. 468 - 473 |
|---|---|
| Main Authors | , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本脳卒中の外科学会
2021
日本脳卒中の外科学会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0914-5508 1880-4683 |
| DOI | 10.2335/scs.49.468 |
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| Abstract | 脳梗塞急性期における治療抵抗性の脳梗塞に対して，過灌流を予防しつつ灌流の不均等さを是正するための手術方式を紹介する．この手技は，1本の浅側頭動脈の途中を側側吻合とし先端部分を端側吻合とすることで，離れた領域に灌流を可能とするものである．提示する症例は79歳の進行性脳梗塞の患者で，浅側頭動脈近位部を側側吻合で側頭葉にバイパスし，次いで遠位部を端側吻合で前頭葉にバイパスした．この手術方法によって，症例は過灌流症状を呈することなく急速な症状改善を示した．この方法は，シングルバイパスでは灌流が不十分となる場合や，過灌流が予想されるような対象に対して有効な対処法かもしれない． |
|---|---|
| AbstractList | 「要旨」脳梗塞急性期における治療抵抗性の脳梗塞に対して, 過灌流を予防しつつ灌流の不均等さを是正するための手術方式を紹介する. この手技は, 1本の浅側頭動脈の途中を側側吻合とし先端部分を端側吻合とすることで, 離れた領域に灌流を可能とするものである. 提示する症例は79歳の進行性脳梗塞の患者で, 浅側頭動脈近位部を側側吻合で側頭葉にバイパスし, 次いで遠位部を端側吻合で前頭葉にバイパスした. この手術方法によって, 症例は過灌流症状を呈することなく急速な症状改善を示した. この方法は, シングルバイパスでは灌流が不十分となる場合や, 過灌流が予想されるような対象に対して有効な対処法かもしれない. 脳梗塞急性期における治療抵抗性の脳梗塞に対して，過灌流を予防しつつ灌流の不均等さを是正するための手術方式を紹介する．この手技は，1本の浅側頭動脈の途中を側側吻合とし先端部分を端側吻合とすることで，離れた領域に灌流を可能とするものである．提示する症例は79歳の進行性脳梗塞の患者で，浅側頭動脈近位部を側側吻合で側頭葉にバイパスし，次いで遠位部を端側吻合で前頭葉にバイパスした．この手術方法によって，症例は過灌流症状を呈することなく急速な症状改善を示した．この方法は，シングルバイパスでは灌流が不十分となる場合や，過灌流が予想されるような対象に対して有効な対処法かもしれない． |
| Author | 一之瀬, 峻輔 佐藤, 篤 佐々木, 哲郎 神谷, 圭祐 本郷, 一博 |
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| References | 7) Inoue A, Kohno K, Iwata S, et al : Efficacy of early superficial temporal artery-middle cerebral artery double anastomoses for atherosclerotic occlusion in patients with progressing stroke. J Stroke Cerebrovasc Dis 26: 741-748, 2017 8) Inoue T, Tamura A, Tsutsumi K, et al : Acute to subacute surgical revascularization for progressing stroke in atherosclerotic vertebrobasilar occlusion. Acta Neurochir（Wien）154: 1455-1461, 2012 21) Wang D, Zhu F, Fung KM, et al : Predicting cerebral hyperperfusion syndrome following superficial temporal artery to middle cerebral artery bypass based on intraoperative perfusion─weighted magnetic resonance imaging. Sci Rep 5: 14140, 2015 3) Goyal M, Menon BK, van Zwam WH, et al : Endovascular thrombectomy after large-vessel ischaemic stroke: A metaanalysis of individual patient data from five randomised trials. Lancet 387: 1723-1731, 2016 15) Mukerji N, Cook DJ, Steinberg GK : Is local hypoperfusion the reason for transient neurological deficits after STA-MCA bypass for moyamoya disease? J Neurosurg 122: 90-94, 2015 11) Kuroda S, Kamiyama H, Abe H, et al : Temporary neurological deterioration caused by hyperperfusion after extracranial-intracranial bypass─case report and study of cerebral hemodynamics. Neurol Med Chir（Tokyo）34: 15-19, 1994 19) Sugiyama T, Kazumata K, Asaoka K, et al : Reappraisal of microsurgical revascularization for anterior circulation ischemia in patients with progressive stroke. World Neurosurg 84: 1579-1588, 2015 16) Muroi C, Khan N, Bellut D, et al : Extracranial-intracranial bypass in atherosclerotic cerebrovascular disease: report of a single centre experience. Br J Neurosurg 25: 357-362, 2011 5) Higashi S, Matsuda H, Fujii H, et al : Luxury perfusion syndrome confirmed by sequential studies of regional cerebral blood flow and volume after extracranial to intracranial bypass surgery: case report. Neurosurgery 25: 85-89, 1989 14) Matano F, Murai Y, Mizunari T, et al : Intracerebral hemorrhage caused by cerebral hyperperfusion after superficial temporal artery to middle cerebral artery bypass for atherosclerotic occlusive cerebrovascular disease. NMC Case Rep J 4: 27-32, 2017 9) Kim JE, Oh CW, Kwon OK, et al : Transient hyperperfusion after superficial temporal artery/middle cerebral artery bypass surgery as a possible cause of postoperative transient neurological deterioration. Cerebrovasc Dis 25: 580-586, 2008 10) Kokuzawa J, Kaku Y, Watarai T, et al : Pure vasogenic edema caused by cerebral hyperperfusion after superficial temporal artery to middle cerebral artery anastomosis─case report. Neurol Med Chir（Tokyo）50: 250-253, 2010 20) Uchino H, Nakayama N, Kazumata K, et al : Edaravone reduces hyperperfusion-related neurological deficits in adult moyamoya disease: Historical control study. Stroke 47: 1930-1932, 2016 13) Mao Z, Li M, Ma Y, et al : Common features in patients with intracerebral hemorrhage following superficial temporal artery-middle cerebral artery bypass in steno-occlusive cerebrovascular disease. Neural Regen Res 7: 1585-1590, 2012 1) Burkhardt JK, Winklhofer S, Fierstra J, et al : Emergency extracranial-intracranial bypass to revascularize salvageable brain tissue in acute ischemic stroke patients. World Neurosurg 109: e476-485, 2018 22) Yoshimoto T, Houkin K, Kuroda S, et al : Low cerebral blood flow and perfusion reserve induce hyperperfusion after surgical revascularization: case reports and analysis of cerebral hemodynamics. Surg Neurol 48: 132-138, 1997 6) Hwang JW, Yang HM, Lee H, et al : Predictive factors of symptomatic cerebral hyperperfusion after superficial temporal artery-middle cerebral artery anastomosis in adult patients with moyamoya disease. Br J Anaesth 110: 773-779, 2013 17) Nussbaum ES, Janjua TM, Defillo A, et al : Emergency extracranial-intracranial bypass surgery for acute ischemic stroke. J Neurosurg 112: 666-673, 2010 12) Lee SB, Huh PW, Kim DS, et al : Early superficial temporal artery to middle cerebral artery bypass in acute ischemic stroke. Clin Neurol Neurosurg 115: 1238-1244, 2013 18) Rahme R, Sudhakar TD, Alimi M, et al : Cerebral hyperperfusion syndrome by the numbers: Transient focal neurological deficit, imaging-proven focal hyperperfusion, and high graft flow rate following superficial temporal artery-middle cerebral artery bypass in a patient with symptomatic carotid occlusion─case report. Oper Neurosurg（Hagerstown）, 15: E94-99, 2018 2) Buxton BF, Hayward PA : The art of arterial revascularization─total arterial revascularization in patients with triple vessel coronary artery disease. Ann Cardiothorac Surg 2: 543-551, 2013 4) Hamamura T, Morioka T, Sayama T, et al : Cerebral hyperperfusion syndrome associated with non-convulsive status epilepticus following superficial temporal artery-middle cerebral artery anastomosis. Case report. Neurol Med Chir（Tokyo）50: 1099-1104, 2010 |
| References_xml | – reference: 9) Kim JE, Oh CW, Kwon OK, et al : Transient hyperperfusion after superficial temporal artery/middle cerebral artery bypass surgery as a possible cause of postoperative transient neurological deterioration. Cerebrovasc Dis 25: 580-586, 2008 – reference: 8) Inoue T, Tamura A, Tsutsumi K, et al : Acute to subacute surgical revascularization for progressing stroke in atherosclerotic vertebrobasilar occlusion. Acta Neurochir（Wien）154: 1455-1461, 2012 – reference: 6) Hwang JW, Yang HM, Lee H, et al : Predictive factors of symptomatic cerebral hyperperfusion after superficial temporal artery-middle cerebral artery anastomosis in adult patients with moyamoya disease. Br J Anaesth 110: 773-779, 2013 – reference: 17) Nussbaum ES, Janjua TM, Defillo A, et al : Emergency extracranial-intracranial bypass surgery for acute ischemic stroke. J Neurosurg 112: 666-673, 2010 – reference: 18) Rahme R, Sudhakar TD, Alimi M, et al : Cerebral hyperperfusion syndrome by the numbers: Transient focal neurological deficit, imaging-proven focal hyperperfusion, and high graft flow rate following superficial temporal artery-middle cerebral artery bypass in a patient with symptomatic carotid occlusion─case report. Oper Neurosurg（Hagerstown）, 15: E94-99, 2018 – reference: 19) Sugiyama T, Kazumata K, Asaoka K, et al : Reappraisal of microsurgical revascularization for anterior circulation ischemia in patients with progressive stroke. World Neurosurg 84: 1579-1588, 2015 – reference: 3) Goyal M, Menon BK, van Zwam WH, et al : Endovascular thrombectomy after large-vessel ischaemic stroke: A metaanalysis of individual patient data from five randomised trials. Lancet 387: 1723-1731, 2016 – reference: 14) Matano F, Murai Y, Mizunari T, et al : Intracerebral hemorrhage caused by cerebral hyperperfusion after superficial temporal artery to middle cerebral artery bypass for atherosclerotic occlusive cerebrovascular disease. NMC Case Rep J 4: 27-32, 2017 – reference: 21) Wang D, Zhu F, Fung KM, et al : Predicting cerebral hyperperfusion syndrome following superficial temporal artery to middle cerebral artery bypass based on intraoperative perfusion─weighted magnetic resonance imaging. Sci Rep 5: 14140, 2015 – reference: 5) Higashi S, Matsuda H, Fujii H, et al : Luxury perfusion syndrome confirmed by sequential studies of regional cerebral blood flow and volume after extracranial to intracranial bypass surgery: case report. Neurosurgery 25: 85-89, 1989 – reference: 15) Mukerji N, Cook DJ, Steinberg GK : Is local hypoperfusion the reason for transient neurological deficits after STA-MCA bypass for moyamoya disease? J Neurosurg 122: 90-94, 2015 – reference: 11) Kuroda S, Kamiyama H, Abe H, et al : Temporary neurological deterioration caused by hyperperfusion after extracranial-intracranial bypass─case report and study of cerebral hemodynamics. Neurol Med Chir（Tokyo）34: 15-19, 1994 – reference: 10) Kokuzawa J, Kaku Y, Watarai T, et al : Pure vasogenic edema caused by cerebral hyperperfusion after superficial temporal artery to middle cerebral artery anastomosis─case report. Neurol Med Chir（Tokyo）50: 250-253, 2010 – reference: 20) Uchino H, Nakayama N, Kazumata K, et al : Edaravone reduces hyperperfusion-related neurological deficits in adult moyamoya disease: Historical control study. Stroke 47: 1930-1932, 2016 – reference: 1) Burkhardt JK, Winklhofer S, Fierstra J, et al : Emergency extracranial-intracranial bypass to revascularize salvageable brain tissue in acute ischemic stroke patients. World Neurosurg 109: e476-485, 2018 – reference: 22) Yoshimoto T, Houkin K, Kuroda S, et al : Low cerebral blood flow and perfusion reserve induce hyperperfusion after surgical revascularization: case reports and analysis of cerebral hemodynamics. Surg Neurol 48: 132-138, 1997 – reference: 2) Buxton BF, Hayward PA : The art of arterial revascularization─total arterial revascularization in patients with triple vessel coronary artery disease. Ann Cardiothorac Surg 2: 543-551, 2013 – reference: 4) Hamamura T, Morioka T, Sayama T, et al : Cerebral hyperperfusion syndrome associated with non-convulsive status epilepticus following superficial temporal artery-middle cerebral artery anastomosis. Case report. Neurol Med Chir（Tokyo）50: 1099-1104, 2010 – reference: 12) Lee SB, Huh PW, Kim DS, et al : Early superficial temporal artery to middle cerebral artery bypass in acute ischemic stroke. Clin Neurol Neurosurg 115: 1238-1244, 2013 – reference: 13) Mao Z, Li M, Ma Y, et al : Common features in patients with intracerebral hemorrhage following superficial temporal artery-middle cerebral artery bypass in steno-occlusive cerebrovascular disease. Neural Regen Res 7: 1585-1590, 2012 – reference: 7) Inoue A, Kohno K, Iwata S, et al : Efficacy of early superficial temporal artery-middle cerebral artery double anastomoses for atherosclerotic occlusion in patients with progressing stroke. J Stroke Cerebrovasc Dis 26: 741-748, 2017 – reference: 16) Muroi C, Khan N, Bellut D, et al : Extracranial-intracranial bypass in atherosclerotic cerebrovascular disease: report of a single centre experience. Br J Neurosurg 25: 357-362, 2011 |
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| Snippet | 脳梗塞急性期における治療抵抗性の脳梗塞に対して，過灌流を予防しつつ灌流の不均等さを是正するための手術方式を紹介する．この手技は，1本の浅側頭動脈の途中を側側吻... 「要旨」脳梗塞急性期における治療抵抗性の脳梗塞に対して, 過灌流を予防しつつ灌流の不均等さを是正するための手術方式を紹介する. この手技は, 1本の浅側頭動脈の途中を側... |
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| SubjectTerms | atherothrombotic cerebral infarction hyperperfusion jumping bypass STA-MCA bypass |
| Title | 急性期の進行性脳梗塞に対するSTA-MCAバイパスに伴うリスク回避のための外科的対処の一方法 ─ジャンピング・バイパスについて |
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