Application Of STA-MCA Bypass Operation In Ischemic Cerebrovascular Diseases

Objective:To explore the therapeutic application of STA-MCA bypass operation in ischemic cerebrovascular diseases and CT cerebral perfusion imaging (CTP) for preoperative and postoperative evaluation of cerebral blood flow and the effect of operation.Msethod:18patients were screened strictly with the ischemic symptoms of unilateral limb weakness, language expression not clear, partial body feels obstacle, headache and dizziness, and Digital Subtraction Angiography (DSA) or CT Angiography (CTA) showing unilateral vascular occlusion or severe stenosis. CTP were carried out preoperatively to make clear the existence of hemodynamic changes, and analysis the coincidence of corresponding clinical symptoms and vascular lesion area by assessing the related index of regions of interest. Evaluating the results of cerebral hemodynamics and clinical manifestations, and selecting patients for STA-MCA bypass operation according to strict inclusion and exclusion criteria. CTP and DSA or CTA were carried out postoperatively and compared with the preoperative results to evaluate the conditions of vascular anastomosis and hemodynamics of surgical patients by measuring related indicators. All the patients were followed up and their neurological deficit before and after the operation were evaluated with the National Institute of Health Stroke Scale (NIHSS). All collected data were analyzed with statistical software SPSS13.0. Results:18cases of bypass operation were successfully completed. Postoperative CTP showed ipsilateral cerebral blood flow was significantly increased (P<0.05), the average transit time decreased significantly (P<0.05), and the peak time also reduced (P<0.05). The NIHSS scores12weeks after operation decreased (P<0.05), and their neurological symptoms obviously improved.Conclusion:STA-MCA bypass could increase the cerebral blood flow of surgical side, alleviate the cerebral blood flow in ischemic region in the short term, and improve the neurological symptoms of patients of the vascular occlusive disease with hemodynamic changes. CTP has certain guiding significance in assessment before and after STA-MCA bypass surgery.