Journal of Korean Society of Geriatric Neurosurgery 2016;12(1):31-37.
Published online June 30, 2016.
Pre- and Post-operative Hemodynamic Assessment after STA-MCA Bypass for Stenoocclusive Diseases in Both Elderly and Non-elderly Patients
Pyeong-Soo Kim , Woo-Keun Kwon , Jong Hyun Kim , Hung-Seob Chung , Taek Hyun Kwon
Department of Neurosurgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
노인 및 비노인 뇌혈관 협착-폐쇄성 질환 환자군에서의 천측두동맥-중뇌동맥 우회술 전, 후의 혈류역학적 비교 평가
고려대학교 의과대학 구로병원 신경외과학교실
Our purpose of this study is to assess the cerebral hemodynamic improvement with perfusion computed tomography (CT), before and after superficial temporal artery (STA) to middle cerebral artery (MCA) bypass surgery in patients with cerebrovascular steno-occlusive diseases, in both the elderly group and non-elderly group.
24 STA-MCA bypasses was performed to 22 patients with symptomatic cerebrovascular steno-occlusive diseases, including both moyamoya disease and other arterial steno-occlusions of the anterior circulation of brain. Brain perfusion CT images were obtained before and after the bypass surgery. The relative parameters of cerebral blood volume (CBV), cerebral blood flow (CBF) and mean transit time (MTT) derived from the perfusion CT were collected and analyzed to assess the efficacy of STA-MCA bypass.
The CBF increased while CBV and MTT decreased in both groups after the STA-MCA bypass operation. The decrease of MTT in non-elderly group, overall group were statistically significant (p<0.05), however other parameters did not show significant differences. During the postoperative follow up period, none of the 22 patients experienced a repeated ischemic/hemorrhagic attacks nor any newly developed neurologic deficits.
STA-MCA bypass seems to be an effective surgical management for patients with cerebrovascular stenoocclusive diseases, for both the elderly group and younger group. And perfusion CT can be used as a non-invasive sufficient quantitative modality to assess the cerebral perfusion before and after the STA-MCA bypass surgery, in both groups.
Key Words: ElderlyㆍSTA-MCA bypassㆍCerebrovascular InsufficiencyㆍCerebrovascular OcclusionㆍPerfusion imaging

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