抄録
The effect of the superficial temporal artery on middle cerebral artery (STA-MCA) anastomosis is discussed and analyzed in 27 cases of occlusive internal carotid artery (ICA) lesion (4 with ICA stenosis and 23 with ICA occlusion) from the viewpoint of retinal circulation using Doppler sonography (DS) and retinal artery pressure (RAP). Preoperatively, DS findings showed the stenosis pattern in 7 cases and the reversed-flow pattern in 19 cases. After bypass, the cases of stenosis pattern showed no prominent change. On the other hand, in the 19 reversed-flow pattern cases. Two cases showed a stenotic normograde flow and 13 showed a decrease of the reversed flow, and greater improvement could be seen in the follow-up stage. Preoperatively, the mean ophthalmic pressure index (OI: the percentage of the mean RAP to the mean systemic blood pressure) of the affected side dropped to 49.5±8.0%(normal side: 65.5±11.8%). After the bypass the mean OI was increased, but it was not statistically significant. In the follow-up stage, visual disturbance could be prevented and improved in all 27 cases. STA-MCA anastomosis appeared to decrease the reversed ophthalmic artery flow, elevate the retinal artery pressure, prevent the worsening of visual acuity and furthermore, improve the decreased visual acuity. It is believed that this procedure is indicated from the effect on the retinal circulation, and STA-MCA anastomosis should be performed to prevent and improve the ischemic retinopathies caused by ischemic ICA lesion.
