特集 血行再建術2：血管吻合術―手術手技
深部バイパスを安全に行うための工夫
キーワード:
deep-seated bypass,
presigmoid transtentorial approach,
cerebrovascular disease,
subtemporal approach
2018 年 46 巻 6 号 p. 449-452
詳細
2018 年 46 巻 6 号 p. 449-452
Deep-seated bypass is one of the most difficult procedures in cerebrovascular surgery. Creating an anastomosis between the superficial temporal artery (STA) and superior cerebellar artery (SCA) using a subtemporal approach is time consuming because the SCA is located deep within the ambient cistern and vein of Labbe and temporal lobe, making it difficult to achieve a wide operative field. We describe a modification of deep-seated bypass using a semi-prone park-bench position and presigmoid transtentorial approach to achieve a wide operative view without temporal lobe injury. This skull base approach may permit an STA-SCA anastomosis within 20 minutes using short forceps.
