頸動脈結紮に関する考察—分別結紮について

LIGATION OF CAROTID ARTERY

I．緒言

　直接手術の困難な頭蓋内の内頸動脈動脈瘤や，後交通動脈動脈瘤，またこの付近の一側性多発動脈瘤などに文して頸動脈結紮が広く採用されてきている。すなわち動脈瘤出血点の血圧下降および動脈瘤中の血栓形成による出血停止および再出血の防止を目的とする術式である。

　この目的に関して頸動脈結紮の予後，成績合併症を左右する因子を考察し，新しい知見を述べたいと思う。

Cervical carotid occlusion as a treatment of intra-craniol aneurysm or A-V malformation has so nume-rous factors effecting on its mechanisms that there is no certain way to investigate all of them at a time to estimate its results in eluding possible complications.

From the basis of various reports on its results a modified method was designed to minimamize its pos-sible complications. The ligations are done both on the common carotid artery and the external carotid artery at its right distal part to the superior thyroid artery. Then the bloodstream, kept going in the inter-nal carotid artery from the superior thyroid artery, prevents possible formation of progressive thrombus. The occlusion of the external carotid artery prevents recovery of the lowered blood pressure in the internal carotid artery caused with the ligation of the common carotid artery.

This method has been applied so far to 9 cases of aneurysm and a typical case was presented here.