Abstract
Currently, the standard clinical procedure for extra- intracranial arterial bypass (EIAB) as treatment for occlusive cerebrovascular disease is anastomosis of the superficial temporal artery (STA) or occipital artery to a cortical branch of the middle cerebral artery (MCA). However, occurrence of the following special circumstances suggests a need for modification of this technique:
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1.
A scalp vessel of adequate (2-mm) diameter may not be available due to anatomic variation, previous trauma, or previous craniotomy.
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2.
Rapid anastomosis is required in cases of progressive stroke or acute stroke due to MCA or internal carotid artery (ICA) occlusion with partial neurologic deficit of 1 to 4 hr duration. Preparation of scalp vessels is tedious and may require from 1 to 3 hr of surgical dissection.
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3.
Small-diameter scalp vessels (1.0 to 1.5 mm) may not provide adequate blood flow for collateral augmentation especially in the acute or progressive cases where the 10 to 30 cm3/min rates measured following anastomosis may be insufficient to prevent infarction before the bypass has matured and the donor vessel enlarged.
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© 1977 Springer-Verlag New York Inc.
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Weinstein, P.R., Chater, N.L., Peters, N.D., Popp, A.J. (1977). Evaluation of 2-mm arterial grafts for extra- to intracranial bypass in occlusive cerebrovascular disease. In: Schmiedek, P., Gratzl, O., Spetzler, R.F. (eds) Microsurgery for Stroke. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-6349-4_18
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DOI: https://doi.org/10.1007/978-1-4612-6349-4_18
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