BRAM, Richard, Zayed ALMADIDY, John SOUTER, Ivana ROŠKOVÁ and Fady T CHARBEL. Vertebral Artery to Middle Cerebral Artery Bypass for Flow Augmentation. Operative Neurosurgery. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS, 2024. ISSN 2332-4252. Available from: https://dx.doi.org/10.1227/ons.0000000000000942.
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Basic information
Original name Vertebral Artery to Middle Cerebral Artery Bypass for Flow Augmentation
Authors BRAM, Richard, Zayed ALMADIDY, John SOUTER, Ivana ROŠKOVÁ and Fady T CHARBEL.
Edition Operative Neurosurgery, PHILADELPHIA, LIPPINCOTT WILLIAMS & WILKINS, 2024, 2332-4252.
Other information
Original language English
Type of outcome Article in a journal
Country of publisher United States of America
Confidentiality degree is not subject to a state or trade secret
WWW URL
Impact factor Impact factor: 2.300 in 2022
Organization unit Faculty of Medicine
Doi http://dx.doi.org/10.1227/ons.0000000000000942
UT WoS 999
Keywords in English Cerebral revascularization; Extracranial intracranial arterial bypass; Interpositional bypass; Vertebral artery
Tags 14110224
Tags International impact, Reviewed
Changed by Changed by: Mgr. Tereza Miškechová, učo 341652. Changed: 29/2/2024 14:36.
Abstract
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.
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