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Анатомо-функциональное обоснование эффективности шунтирования позвоночной артерии сосудом из системы наружной сонной артерии
Aim. To evaluate the anatomical and functional feasibility and adequacy of performing intersystem anastomosis during bypass surgery of the vertebral artery with an vessel from the external carotid artery system. Material and methods. On the basis of ultrasound Dopplerography of 1,074 people, the dimensions and hemodynamic parameters of the external carotid and vertebral arteries, the calculation of the volumetric blood flow velocity and the diameter of the shunt sufficient to replenish blood supply in each individual case were studied. All the surveyed were divided into 4 age groups: 1) under 35 years old, 2) from 36 to 60 years old, 3) from 61 to 71 years old, 4) over 76 years old. Statistical analysis of the results was performed using IBM SPSS Statistics 20. Results. When forming a shunt with a diameter of 2.5–3.0 mm, the volume of replaced blood flow will be 134–194% of the initial values, with a diameter of 2.0 mm — 86%, with a diameter of 1.5 mm shunt — up to 48% of the volume blood flow for the vertebral artery. Conclusions. The study contributes to the development of new and improved existing methods of carotid spine bypass surgery based on data on the functional and morphometric features of these vessels in men and women of different age groups. Based on the calculations, the criteria for the sufficiency of the required diameter of the bypass vessel are justified. In most cases, the desired effect of surgical treatment can be achieved with a diameter of 2.0–2.5 mm shunts. In cases of small size of the required diameter, it is preferable to use an arterial autograft, and in cases of large size, a venous one. These features are relevant for performing reconstructive surgeries with a personalized carotid-spinal bypass approach.