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首页> 外文期刊>Neurosurgical review. >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
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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

机译：颅内-颅内旁路术治疗内部颈动脉/中部动脉粥样硬化狭窄闭塞性疾病并结合颈动脉内膜切除术治疗对侧颈动脉狭窄：临床结果和认知表现

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Clinical results as well as cognitive performances after extracranial to intracranial (EC-IC) bypass in conjunction with contralateral carotid endarterectomy (CEA) are poorly understood. Data from 14 patients who underwent unilateral EC-IC bypass for atherosclerotic internal carotid artery (ICA)/middle cerebral artery (MCA) steno-occlusive disease in conjunction with CEA for contralateral cervical carotid stenosis were retrospectively reviewed. Postoperative results were evaluated by MRI imagings. Nine patients also underwent neuropsychological examinations (NPEs), including assessment by the Wechsler Adult Intelligence Scale-Third Edition and the Wechsler Memory Scale-Revised (WMS-R) before and about 6 months after bilateral surgeries. Postoperative MRI follow-up (median, 8 months; interquartile range, 7-8 months) confirmed successful bypass in all patients, with no additional ischemic lesions on T2WI when compared with preoperative imaging. Further, MRA showed patent bypass and contralateral smooth patency at CEA portion in all patients. In the group rate analysis, all five postoperative NPE scores (Verbal IQ, Performance IQ, WMS-memory, WMS-attention, and Average scores of all those four scores) were improved relative to preoperative NPE scores. Performance IQ and Average score improvements were statistically significant. Clinical results after EC-IC bypass in conjunction with contralateral CEA were feasible. Based on the group rate analysis, we conclude that successful unilateral EC-IC bypass and contralateral carotid endarterectomy does not adversely affect postoperative cognitive function.
机译：颅外转颅内（EC-IC）旁路与对侧颈动脉内膜切除术（CEA）结合后的临床结果以及认知表现知之甚少。回顾性分析了14例接受单侧EC-IC旁路术治疗伴有对侧颈动脉狭窄的动脉粥样硬化性颈内动脉（ICA）/大脑中动脉（MCA）狭窄闭塞性疾病以及CEA的患者的数据。术后结果通过MRI成像评估。 9名患者还接受了神经心理学检查（NPE），包括在双边手术前后约6个月进行的韦氏成人智力量表第三版和韦氏记忆量表修订版（WMS-R）的评估。术后MRI随访（中位8个月;四分位间距7-8个月）证实所有患者均成功旁路手术，与术前影像学检查相比，T2WI上无其他缺血性病变。此外，MRA在所有患者中均显示CEA部分有专利旁路和对侧平滑通畅。在组比率分析中，所有五个术后NPE得分（言语智商，表现智商，WMS记忆，WMS注意力和这四个得分的平均得分）均比术前NPE得分有所提高。绩效智商和平均得分的提高在统计学上是显着的。 EC-IC旁路联合对侧CEA后的临床结果是可行的。基于组率分析，我们得出结论，成功的单侧EC-IC旁路和对侧颈动脉内膜切除术不会对术后认知功能产生不利影响。

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