Preoperative detailed evaluation intracranial artery stenosis using three-dimensional visualization analysis reduces the invasiveness of superficial temporal artery-middle cerebral artery bypass.

Fujita Medical Journal Pub Date : 2023-08-01 DOI:10.20407/fmj.2022-022

Riki Tanaka, Fuminari Komatsu, Kento Sasaki, Kyosuke Miyatani, Yasuhiro Yamada, Yoko Kato, Yuichi Hirose

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Abstract

Objectives: Superficial temporal artery (STA) to middle cerebral artery (MCA) bypass surgery is a common treatment for preventing cerebral ischemia in patients with intracranial artery stenosis. The aim of this study was to analyze the surgical outcomes of the STA-MCA bypass procedure, particularly with regard to the invasiveness of targeted bypass (TB) with preoperative planning using Amira^® software.

Methods: Consecutive patients with single STA-MCA bypass performed by a single neurosurgeon from January 2019 to May 2022 were included. The clinical parameters of seven TB patients were compared with those of 11 patients treated with the conventional method (CM).

Results: Compared with CM patients, TB using Amira^® software patients had a shorter scalp incision (median [interquartile range]=11.2 [9.7-12.7] cm vs. 16.9 [16.0-17.7] cm, respectively; p=0.004], smaller craniotomy size (11.8 [11.5-14.4] cm² vs. 20.9 [17.1-22.2] cm², respectively; p=0.01], shorter surgery duration (201 [195-218] min vs. 277 [229-310] min, respectively; p=0.003], and less intraoperative bleeding (10 [10-20] g vs. 23 [20-50] g, respectively; p=0.033]. However, there were no differences in surgical complications between the two groups.

Conclusions: Detailed preoperative evaluation using Amira^® software can reduce the invasiveness of the STA-MCA bypass procedure.

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术前应用三维可视化分析详细评价颅内动脉狭窄，减少颞浅动脉-大脑中动脉搭桥术的侵入性。

目的:颞浅动脉(STA)至大脑中动脉(MCA)搭桥手术是预防颅内动脉狭窄患者脑缺血的常用治疗方法。本研究的目的是分析STA-MCA搭桥手术的手术结果，特别是使用Amira®软件进行术前规划的靶向搭桥(TB)的侵入性。方法:纳入2019年1月至2022年5月由同一名神经外科医生进行的单次STA-MCA搭桥手术的连续患者。将7例结核患者的临床参数与11例常规治疗方法(CM)的临床参数进行比较。结果:与CM患者相比，使用Amira®软件的TB患者的头皮切口更短(中位数[四分位数间距]=11.2 [9.7-12.7]CM vs. 16.9 [16.0-17.7] CM;P =0.004]，开颅面积较小(分别为11.8 [11.5-14.4]cm2比20.9 [17.1-22.2]cm2;P =0.01]，手术时间较短(201 [195-218]min vs. 277 [229-310] min);P =0.003]，术中出血较少(10 [10-20]g vs. 23 [20-50] g;p = 0.033)。然而，两组在手术并发症方面没有差异。结论:使用Amira®软件进行详细的术前评估可以减少STA-MCA搭桥手术的侵入性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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