Extracranial to Intracranial Microvascular Anastomosis: A New Approach to the Treatment of Cerebrovascular Disease

  • Gary G. Ferguson
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 82)


It is estimated that in the United States alone, 200,000 new strokes occur annually, of which, at least 10% are the result of multiple extracranial or surgically inaccessible intracranial lesions, considered “inoperable” by conventional techniques (1). Recent advances in microsurgery allow revascularization to be undertaken in such patients. The most widely used procedure, first performed by Yasargil in 1967, is an end-to-side anastomosis between the superficial temporal artery and a cortical branch of the middle cerebral artery, vessels only slightly greater than 1 mm in diameter (4). Experience to date indicates that operative mortality and morbidity is less than 5% and that long term anastomosis patency rates approaching 100% are possible (2, 3). The principal difficulty with the procedure has been accurate delineation of the indications for its use in view of the broad clinical spectrum of cerebrovascular disease and the wide variety of lesions which may result in threatened or actual stroke.


Superficial Temporal Artery Cerebral Vascular Disease Microvascular Anastomosis Accurate Delineation Blood Flow Study 
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  1. 1.
    Chater, N., Mani, J., Tonnemacher, K.: Superficial temporal ar tery bypass in occlusive cerebral vascular disease. Calif. Med. 119: 9–13, 1973.PubMedGoogle Scholar
  2. 2.
    Gratzl, O., Schmiedek, P., Spetzler, R., Steinhoff, H., Marguth, F.: Clinical experience with extra-intracranial anastomosis in 65 cases. J. Neurosurg. (in press)Google Scholar
  3. 3.
    Reichman, O.H.: Extracranial-intracranial arterial anastomosis. In: Whisnant, J.P., Sandok, B.A. (eds.): Cerebral Vascular Diseases, Ninth Conference. New York, Grune and Stratton, 1975, pp. 175–186.Google Scholar
  4. 4.
    Yasargil, M.G.: Microsurgery Applied to Neurosurgery. New York, Academic Press, 1969, pp. 105–115.Google Scholar

Copyright information

© Plenum Press, New York 1977

Authors and Affiliations

  • Gary G. Ferguson
    • 1
  1. 1.Division of Neurosurgery, Department of Clinical Neurological SciencesThe University of Western Ontario, University HospitalLondonCanada

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