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Abstract：
The approach to surgical treatment of symptomatic bilateral dolichoarteriopathies of the internal carotid artery (DICA) remains an unresolved problem today. The aim of this article is to compare the methods of reconstruction of the stage-by-stage surgical treatment of bilateral DICA, depending on the type of deformity. The study included 30 patients with clinical manifestations of cerebrovascular insufficiency (CVI), who were found to have hemodynamically significant bilateral DICA. The patients underwent stage-by-stage operations on both sides, resulting in a total of 60 reconstructive operations on the carotid arteries. Based on the type of reconstruction, the patients were divided into three groups. All three groups showed positive dynamics with relief of the CVI clinical symptoms ( p = 0.01), except for patients with persistent residual effects after strokes. Hemodynamic indices in the ICA also normalized after surgery; the linear velocity of blood flow decreased to 0.842 ± 0.087 m/s ( p = 0.01) in the first group, 0.825 ± 0.057 m/s ( p = 0.01) in the second group, and 0.805 ± 0.083 m/s ( p = 0.01) in the third group. The results of the treatment of bilateral DICA showed that with a correctly selected approach to stage-by-stage surgical treatment, it is possible to achieve restoration of blood flow along the internal carotid artery with regression of general cerebral symptoms.
摘要：
目前，有症状的颈内动脉（DICA）双侧细动脉病变的手术治疗方法仍未解决。本文的目的是比较双侧DICA的分期手术治疗的重建方法，取决于畸形的类型。该研究包括30例临床表现为脑血管功能不全（CVI）的患者，他们被发现有血液动力学显著的双侧DICA。患者双方进行了分期手术,总共进行了60次颈动脉重建手术。根据重建的类型，患者分为三组。所有三组均显示出CVI临床症状缓解的阳性动力学（p=0.01），除了中风后有持续残留效应的患者。手术后ICA的血流动力学指标也恢复正常；第一组的血流线速度降至0.842±0.087m/s（p=0.01），第二组0.825±0.057m/s（p=0.01），第三组为0.805±0.083m/s(p=0.01)。双侧DICA的治疗结果表明，在正确选择分期手术治疗方法的情况下，随着一般脑症状的消退，可以恢复沿颈内动脉的血流。
