Bypass Surgery for Ischemic Cerebrovascular Disease
There continues to be debate about the effectiveness of and indication for extracranial to intracranial arterial bypass surgery (EIAB) as therapy for ischemic cerebrovascular disease. Particularly noteworthy are the negative conclusions drawn from the International Cooperative Study , which was undertaken to determine the effectiveness of such surgery in preventing the recurrence of transient ischemic attacks (TIAs) or reversible ischemic neurological deficits (RINDs). It has also been reported, however, that EIAB normalizes disturbances of cerebral hemodynamics [6, 9] and, indeed, the results of the International Cooperative Study itself did not indicate that EIAB surgery was ineffective in all varieties of ischemic cerebrovascular disease. Moreover, in light of the fact that, at an early stage following EIAB for slow progressing stroke, there is marked improvement in symptoms , effective results following vascular reconstruction can be expected in many patients in which ischemic symptoms have arisen due to hemodynamic mechanisms.
KeywordsCerebral Blood Flow Middle Cerebral Artery Middle Cerebral Artery Occlusion Superficial Temporal Artery Vascular Reconstruction
Unable to display preview. Download preview PDF.
- 5.Gentou E, Barnett HJM, Feieids WS (1977) Cerebral ischemia: The role of thrombosis and antithrombotic therapy. Study group on antithrombotic therapy. Stroke 8:150–175Google Scholar
- 9.Yamamoto YL, Little J, Thompson C, Meyer E, Feindel W (1979) Positron tomography with krypton-77 for evaluation of topographical rCBF changes following EC-IC bypass surgery. In: Gotoh F, et al. (eds) 9th International Symposium of Cerebral Blood Flow and Metabolism, pp 522-523Google Scholar