An experimental study on antispasmodic treatment of superficial temporal artery graft during revascularization for moyamoya disease

Abstract

Objective To compare the antispasmodic effects of nitroglycerin, nimodipine and diltiazem on the superficial temporal artery(STA) during the superficial temporal artery-middle cerebral artery bypass (STA-MAC). Methods A total of sixty- five patients with moyamoya disease who underwent STA-MAC were divided into three groups according to random number table. GroupⅠ was administered nitroglycerin (n=22), groupⅡ was given nimodipine (n=22), and group Ⅲ was given diltiazem (n=21). The patients were continuously pumped with 0.3-0.5 μg·kg-1·min-1 during the surgery. Then, the maximum flow velocity (Vmax), the minimum flow velocity (Vmin), the mean flow velocity (Vm), resistance index (RI), and inside diameter (ID) of the STA before graft (T1), immediately after extubation (T2) and three days after operation (T3) were recorded using vascular ultrasound. Meanwhile, the mean arterial pressure (MAP), heart rate and central venous pressure (CVP) were recorded. Results The three groups showed remarkably increased Vmax, Vmin, and Vm, and ID and decreased RI at T3 compared with those at T1 (P 0.05). Conclusions Nimodipine and diltiazem are superior to nitroglycerin in the diastolic and antispasmodic effects on STA-MAC. Key words: Moyamoya disease; Superficial temporal artery-middle cerebral artery bypass; Nitroglycerin; Nimodipine; Diltiazem