Advertisement

Bypass Surgery for Ischemic Cerebrovascular Disease

  • Akira Ogawa
  • Yoshiharu Sakurai
  • Takashi Yoshimoto
  • Motonobu Kameyama
  • Jiro Suzuki
  • Masatoshi Itoh

Abstract

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 [8], 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 [7], effective results following vascular reconstruction can be expected in many patients in which ischemic symptoms have arisen due to hemodynamic mechanisms.

Keywords

Cerebral Blood Flow Middle Cerebral Artery Middle Cerebral Artery Occlusion Superficial Temporal Artery Vascular Reconstruction 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Ausman JI, Diaz FG (1986) Critique of the extracranial-intracranial bypass study. Surg Neurol 26:218–221PubMedCrossRefGoogle Scholar
  2. 2.
    Baron JC, Bousser MG, Rey A, Guillard A, Comar D, Castaigne P (1981) Reversal of focal “miseryperfusion syndrome” by extra-intracranial arterial bypass in hemodynamic cerebral ischemia. A case study with 15O positron emission tomography. Stroke 12:454–459PubMedCrossRefGoogle Scholar
  3. 3.
    Day AL, Rhoton AL Jr, Little JR (1986) The extracranial-intracranial bypass study. Surg Neurol 26:222–226PubMedCrossRefGoogle Scholar
  4. 4.
    Diaz FG, Ausman JI, Mehta B, Dujovny M, Reyes RA, Pearce J, Patel S (1985) Acute cerebral revascularization. J Neurosurg 63:200–209PubMedCrossRefGoogle Scholar
  5. 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
  6. 6.
    Samson Y, Baron JC, Bousser MG, Dderlon JM, David P, Comoy J (1985) Effects of extra-intracranial arterial bypass on cerebral blood flow and oxygen metabolism in humans. Stroke 16:609–616PubMedCrossRefGoogle Scholar
  7. 7.
    Suzuki J (1987) Treatment of cerebral infarction: Experimental and clinical study. Springer, ViennaCrossRefGoogle Scholar
  8. 8.
    The EC/IC Bypass Study Group (1985) Failure of extracranial-intracranial arterial bypass to reduce the risk of ischemic stroke. Results of an international randomized trial. N Engl J Med, 19:1191–1200CrossRefGoogle Scholar
  9. 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

Copyright information

© Springer Japan 1988

Authors and Affiliations

  • Akira Ogawa
    • 1
  • Yoshiharu Sakurai
    • 1
  • Takashi Yoshimoto
    • 2
  • Motonobu Kameyama
    • 2
  • Jiro Suzuki
    • 2
  • Masatoshi Itoh
    • 3
  1. 1.Department of Neurosurgery, Stroke CenterSendai National HospitalSendaiJapan
  2. 2.Division of Neurosurgery, Institute of Brain DiseasesTohoku University, School of MedicineSendaiJapan
  3. 3.Division of Nuclear Medicine, Cyclotron RI CenterTohoku UniversitySendaiJapan

Personalised recommendations