Extra-intracranial Anastomoses

  • H. M. Mehdorn

Abstract

Thanks to the development of microsurgical techniques and their use in neurosurgery [30], CM. Fischer’s idea (1951) of successfully bypassing an occluded cervical artery has become a reality. This operation, the extra-intracranial arterial bypass operation (also called extra-intracranial anastomosis, abbreviated here as EIAB) has gained increasing popularity in the last few years, following the first operation by Yasargil in 1967. The patency rates of extra-intracranial anastomosis are approximately 95%. The extracranial donor artery, initially having a flow of only about 20 ml/min may be significantly dilated postoperatively and provide a flow of more than 150 ml/min into the intracranial vascular system.

Keywords

Ischemia Foam Rubber Heparin Neurol 

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References

  1. 1.
    Ausman JI, Nicoloff DM, Chou SN (1978) Posterior fossa revascularization: Anastomosis of vertebral artery to PICA with interposed radial artery graft. Surg Neurol 9:281–286PubMedGoogle Scholar
  2. 2.
    Ausman JI, Lee MC, Chater NL, Latchaw RE (1979) Superficial temporal artery to superior cere bellar artery anastomosis for distal basilar artery stenosis. Surg Neurol 12:277–282PubMedGoogle Scholar
  3. 3.
    Ausman JI, Diaz FG, de los Reyes RA, Pak H, Patel S, Boulos R (1981) Anastomosis of occipital artery to anterior inferior cerebellar artery for vertebrobasilar junction stenosis. Surg Neurol 16:99–102PubMedCrossRefGoogle Scholar
  4. 4.
    Ausman JI, Diaz FG, de los Reyes RA, Pak H, Patel S, Boulos R (1981) Superficial temporal to proximal superior cerebellar artery anastomosis for basilar artery stenosis. Neurosurgery 9:56–66PubMedCrossRefGoogle Scholar
  5. 5.
    Chater NL, Spetzler RF, Tonnemacher K, Wilson CB (1976) Microvascular bypass surgery. Part 1: Anatomical studies. J Neurosurg 44:712–714PubMedCrossRefGoogle Scholar
  6. 6.
    EC/IC Bypass Study Group (1985) Failure of extracranial-intracranial arterial bypass to reduce the risk of ischemic stroke. N Engl J Med 313:1191–1200Google Scholar
  7. 7.
    Fisher CM (1951) Occlusion of the internal carotid artery. Arch Neurol Psych 65:346–377Google Scholar
  8. 8.
    Gilsbach JM (1983) Intraoperative Doppler sonography in neurosurgery. Springer, Wien New YorkGoogle Scholar
  9. 9.
    Goldsmith HS, Chen WF, Duckett SW (1973) Brain vascularization by intact omentum. Arch Surg 106:695–698PubMedCrossRefGoogle Scholar
  10. 10.
    Jamjoom ZA, Mehdorn HM, Nahser HC (1983) Comparative study of Doppler sonography and angiography in extracranial-intracranial anastomosis. Adv Neurosurg 11:375–383Google Scholar
  11. 11.
    Karasawa J, Kikuchi H, Furuse S, Kawamura J, Sakaki T (1978) Treatment of moyamoya disease with STA-MCA anastomosis. J Neurosurg 49:679–688PubMedCrossRefGoogle Scholar
  12. 12.
    Karasawa J, Kikuchi H, Kawamura J, Sakaki T (1980) Intracranial transplantation of the omentum for cerebrovascular moyamoya disease: A two-year follow-up study. Surg Neurol 14:444–449PubMedGoogle Scholar
  13. 13.
    Kearns TP, Siekert RG, Sundt TM Jr (1978) The ocular aspects of carotid artery bypass surgery. Trans Am Ophthalmol Soc 76:247–265PubMedGoogle Scholar
  14. 14.
    Khodadad G, Singh RS, Olinger CP (1977) Possible prevention of stroke by microvascular anastomosis in the vertebral basilar system. Stroke 8:316–321PubMedCrossRefGoogle Scholar
  15. 15.
    Kletter G (1979) The extra-intracranial bypass operation for prevention and treatment of stroke. Springer, Wien New YorkGoogle Scholar
  16. 16.
    Kletter G, Matras H, Dinges HP (1978) Zur partiel-len Klebung von Mikrogefäßanastomosen im in-trakraniellen Bereich. Wien Klin Wochenschr 90:415–419PubMedGoogle Scholar
  17. 17.
    Laurent JP, Lawner PM, O’Connor M (1982) Reversal of intracerebral steal by STA-MCA anastomosis. J Neurosurg 57:629–632PubMedCrossRefGoogle Scholar
  18. 18.
    Little JR, Salerno TA (1978) Continuous suturing for microvascular anastomosis. Technical note. J Neurosurg 48:1042–1045PubMedCrossRefGoogle Scholar
  19. 19.
    Mehdorn HM, Hoffman WF, Chater NL (1979) Microvascular neurosurgical arterial bypass for cerebral ischämia. A decade of development. World J Surg 3:197–206PubMedCrossRefGoogle Scholar
  20. 20.
    Mehdorn HM (1980) Mikroneurochirurgische The-rapie der zerebralen Ischamie. Z Allg Med 56:1731–1737Google Scholar
  21. 21.
    Peerless SJ (1975) Techniques of cerebral revascularization. Clin Neurosurg 23:258–269Google Scholar
  22. 22.
    Peerless SJ, Gamache FW Jr, Hunter IG (1981) Continuous suture method for microvascular anastomosis. Technical note. Neurosurgery 8:695–698PubMedCrossRefGoogle Scholar
  23. 23.
    Piepgras DG, Sundt TM Jr (1982) Operative management of intracranial arterial occlusions and acute ischemic stroke. In: Youmans JR (ed) Neurological surgery, vol 3. Saunders, Philadelphia London Toronto Mexico City Tokyo, pp 1619–1626Google Scholar
  24. 24.
    Spetzler R, Chater N (1974) Occipital artery-middle cerebral artery anastomosis for cerebral artery occlusive disease. Surg Neurol 2:235–238PubMedGoogle Scholar
  25. 25.
    Spetzler RF, Rhodes RS, Roski RA, Likavec MJ (1980) Subclavian to middle cerebral artery saphenous vein bypass graft. J Neurosurg 53:465–469PubMedCrossRefGoogle Scholar
  26. 26.
    Spetzler RF, Schuster H, Roski RA (1980) Elective extracranial-intracranial artery bypass in the treatment of inoperable giant aneurysms of the internal carotid artery. J Neurosurg 53:22–27PubMedCrossRefGoogle Scholar
  27. 27.
    Sundt TM Jr, Piepgras DG (1978) Occipital artery to posterior inferior cerebellar artery bypass surgery. J Neurosurg 48:916–928PubMedCrossRefGoogle Scholar
  28. 28.
    Sundt TM Jr, Piepgras DG, Houser OW, Campbell JK (1982) Interposition saphenous vein grafts for advanced occlusive disease and large aneurysm in the posterior circulation. J Neurosurg 56:205–215PubMedCrossRefGoogle Scholar
  29. 29.
    Woringer E, Kunlin J (1963) Anastomose entre la carotide primitive et la carotide intracranienne ou la sylvienne par greffon selon la technique de la suture suspendue. Neurochirurgie 9:181–188PubMedGoogle Scholar
  30. 30.
    Yasargil MG (1969) Microsurgery applied to neurosurgery. Thieme, Stuttgart. Academic, New YorkGoogle Scholar
  31. 31.
    Yasargil MG, Yonekawa Y (1977) Results of microsurgical extra-intracranial arterial bypass in the treatment of cerebral ischemia. Neurosurgery 1:22–24PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1989

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  • H. M. Mehdorn

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