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 Ⅱバイパス術の実際

手術手技の流派を知るⅢ：バリエーション手技—緊急血行再建にも耐え得る，STA-MCAバイパス手術手技

著者： 井上智弘¹ 小原健太² 小野秀明³

所属機関： ¹NTT東日本関東病院脳神経外科 ²東京大学脳神経外科 ³富士脳障害研究所附属病院脳神経外科

ページ範囲：P.773 - P.778

Point
・STA採取時，小枝はSTA本幹側に熱損傷が及ばないよう丁寧に凝固する．
・Donorおよびrecipientのサイズのバランスに配慮し，縫合時は全層かつ内皮をしっかり貫く．
・塞栓摘出時は，横切開が再建時に縫合しやすく有効である．
＊本論文中、［Video］マークのある図につきましては、関連する動画を見ることができます（公開期間：2025年8月まで）。

参考文献

1）Inoue T, et al：Training of A3-A3 side-to-side anastomosis in a deep corridor using a box with 6.5-cm depth：technical note. Surg Neurol 66：638-641, 2006

2）Inoue T, et al：Effectiveness of suturing training with 10-0 nylon under fixed and maximum magnification（x 20）using desk type microscope. Surg Neurol 66：183-187, 2006

3）Inoue T, et al：Emergent surgical embolectomy in conjunction with cervical internal carotid ligation and superficial temporal artery-middle cerebral artery bypass to treat acute tandem internal carotid and middle cerebral artery occlusion due to cervical internal carotid artery dissection. Surg Neurol Int 6：191, 2015

4）Inoue T, et al：Surgical embolectomy for internal carotid artery terminus occlusion. Neurosurg Rev 38：661-669, 2015

5）Hasegawa H, et al：Emergent intracranial surgical embolectomy in conjunction with carotid endarterectomy for acute internal carotid artery terminus embolic occlusion and tandem occlusion of the cervical carotid artery due to plaque rupture. J Neurosurg 122：939-947, 2015

6）Kiyofuji S, et al：Emergent surgical embolectomy for middle cerebral artery occlusion due to carotid plaque rupture followed by elective carotid endarterectomy：a case report. J Neurosurg 121：631-636, 2014

7）Inoue T, et al：Surgical embolectomy for large vessel occlusion of anterior circulation. Br J Neurosurg 27：783-790, 2013

8）Inoue T, et al：Acute to subacute surgical revascularization for progressing stroke in atherosclerotic vertebrobasilar occlusion. Acta Neurochir（Wien）154：1455-1461；discussion 1461, 2012

9）Inoue T, et al：Extracranial-intracranial bypass for internal carotid/middle cerebral atherosclerotic steno-occlusive diseases in conjunction with carotid endarterectomy for contralateral cervical carotid stenosis：clinical results and cognitive performance. Neurosurg Rev 39：633-641, 2016

10）Inoue T, et al：Postoperative transient neurological symptoms and chronic subdural hematoma after extracranial-intracranial bypass for internal carotid/middle cerebral atherosclerotic steno-occlusive diseases：negative effect on cognitive performance. Acta Neurochir（Wien）158：207-216, 2016