Neurological Surgery 脳神経外科50巻4号

2022年07月発行

特集 STA-MCAバイパス術—日本が世界に誇る技を学ぶ Ⅰバイパス術の適応

対象疾患

著者： 堀江信貴¹ 岡崎貴仁¹

所属機関： ¹広島大学大学院医系科学研究科脳神経外科学

ページ範囲：P.727 - P.734

Point
・これまでのランダム化比較試験の結果からは症候性内頚動脈および中大脳動脈閉塞，狭窄症に対するバイパス術は十分なエビデンスが確立されていない．
・最終発作から3週間経過した後の脳循環測定にて安静時脳血流が正常値80%未満，かつアセタゾラミド血管反応性10%未満に対してはバイパス術の有効性が期待される．
・周術期管理が重要であり，血圧変動に伴う脳虚血や術後過灌流に留意する．
・もやもや病においては虚血発症だけでなく，出血発症に対してもバイパス術の効果が期待される．

参考文献

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