吻合術における浅側頭動脈切断面の病理学的検討 ─2症例での検討─

抄録

Objective: Although superficial temporal artery (STA)-middle cerebral artery (MCA) bypass is an established cerebral revascularization procedure, injuries to the vascular wall and occlusion of the anastomoses have been reported as complications of the procedure. We performed histological examination of the cut edge of the STA obtained from an STA-MCA bypass and investigated the injury.
Materials and Methods: Two STA specimens were obtained from two STA-MCA bypass procedures. One specimen was cut using micro-scissors. The other specimen was slightly long and was cut with micro- and macro-scissors and with a micro-knife on a cotton sheet. Each specimen was stained and examined using Elastica-Masson stain and hematoxylin-eosin stain.
Results: In the specimen cut using micro-scissors alone, all layers of the vascular wall were thinned, and the media was injured. In the specimen cut using macro-scissors, the outer membrane was injured, and the intima and media were dissected. In the specimen placed on a cotton sheet and cut with a micro-knife, no thinning of the layers of the vascular wall or dissection between layers was noted.
Conclusions: Applying pressure to the vascular wall using scissors can injure the vascular wall and result in dissection between layers.