J 2024

Vertebral Artery to Middle Cerebral Artery Bypass for Flow Augmentation

BRAM, Richard, Zayed ALMADIDY, John SOUTER, Ivana ROŠKOVÁ, Fady T CHARBEL et. al.

Basic information

Original name

Vertebral Artery to Middle Cerebral Artery Bypass for Flow Augmentation

Authors

BRAM, Richard, Zayed ALMADIDY, John SOUTER, Ivana ROŠKOVÁ (703 Slovakia, belonging to the institution) and Fady T CHARBEL (guarantor)

Edition

Operative Neurosurgery, PHILADELPHIA, LIPPINCOTT WILLIAMS & WILKINS, 2024, 2332-4252

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30212 Surgery

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 2.300 in 2022

Organization unit

Faculty of Medicine

UT WoS

001156436600025

Keywords in English

Cerebral revascularization; Extracranial intracranial arterial bypass; Interpositional bypass; Vertebral artery

Tags

Tags

International impact, Reviewed
Změněno: 10/6/2024 10:13, Mgr. Tereza Miškechová

Abstract

V originále

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.