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@article{2332058,
author = {Bram, Richard and Almadidy, Zayed and Souter, John and Rošková, Ivana and Charbel, Fady T},
article_location = {PHILADELPHIA},
doi = {http://dx.doi.org/10.1227/ons.0000000000000942},
keywords = {Cerebral revascularization; Extracranial intracranial arterial bypass; Interpositional bypass; Vertebral artery},
language = {eng},
issn = {2332-4252},
journal = {Operative Neurosurgery},
title = {Vertebral Artery to Middle Cerebral Artery Bypass for Flow Augmentation},
url = {https://journals.lww.com/onsonline/fulltext/9900/vertebral_artery_to_middle_cerebral_artery_bypass.932.aspx},
year = {2024}
}
TY - JOUR
ID - 2332058
AU - Bram, Richard - Almadidy, Zayed - Souter, John - Rošková, Ivana - Charbel, Fady T
PY - 2024
TI - Vertebral Artery to Middle Cerebral Artery Bypass for Flow Augmentation
JF - Operative Neurosurgery
PB - LIPPINCOTT WILLIAMS & WILKINS
SN - 23324252
KW - Cerebral revascularization
KW - Extracranial intracranial arterial bypass
KW - Interpositional bypass
KW - Vertebral artery
UR - https://journals.lww.com/onsonline/fulltext/9900/vertebral_artery_to_middle_cerebral_artery_bypass.932.aspx
N2 - Background and importance: Extracranial-intracranial bypass remains an enduring procedure for a select group of patients suffering from steno-occlusive cerebrovascular disease. Although the superficial temporal artery (STA) to middle cerebral artery (MCA) bypass is most familiar among neurosurgeons, particular circumstances preclude the use of an STA donor. In such cases, alternative revascularization strategies must be pursued. Clinical presentation: A 63-year-old female presented with symptoms of hemodynamic insufficiency and was found to have left common carotid artery occlusion at the origin. She experienced progressive watershed ischemia and pressure-dependent fluctuations in her neurological examination despite maximum medical therapy. The ipsilateral STA was unsuitable for use as a donor vessel. We performed an extracranial vertebral artery (VA) to MCA bypass with a radial artery interposition graft. Conclusion: This technical case description and accompanying surgical video review the relevant anatomy and surgical technique for a VA-MCA bypass. The patient was ultimately discharged home at her preoperative neurological baseline with patency of the bypass. The VA can serve as a useful donor vessel for cerebral revascularization procedures in pathologies ranging from malignancies of the head and neck to cerebral aneurysms and cerebrovascular steno-occlusive disease.
ER -
BRAM, Richard, Zayed ALMADIDY, John SOUTER, Ivana ROŠKOVÁ a Fady T CHARBEL. Vertebral Artery to Middle Cerebral Artery Bypass for Flow Augmentation. \textit{Operative Neurosurgery}. PHILADELPHIA: LIPPINCOTT WILLIAMS \&{} WILKINS, 2024. ISSN~2332-4252. Dostupné z: https://dx.doi.org/10.1227/ons.0000000000000942.
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