Bypass Graft for Cerebral Revascularization

Rha, Hyoung Kyun; Lee, Kyung Jin; Cho, Kyung Keun; Park, Sung Chan; Park, Hae Kwan; Cho, Jung Ki; Kang, Joon Ki; Choi, Chang Rak

Abstract

OBJECTIVE
The authors were performed bypass graft for cerebral revascularization in the treatment of hemodynamic cerebral ischemia and unclippable traumatic aneurysm, which acute sacrifice of the internal carotid artery is necessary. The aim of this study was to assess effectiveness bypass graft for cerebral revascularization. METHOD: Of 6 patients, Four patients were hemodynamic cerebral ischemia and two patients were traumatic cerebral aneurysm and traumatic carotid-cavernous fistula (CCF). Revascularization was performed external carotid artery (ECA) to middle cerebral artery (MCA) bypass with radial artery (n=1), ECA to MCA bypass with long saphenous vein (n=1), main trunk of superficial temporal artery (STA) to MCA with short saphenous vein (n=2), and internal carotid artery (ICA) to MCA with long saphenous vein (n=2).
RESULTS
There were two graft occlusion, which one is recanalization case of preoperative MCA obstruction and the other is traumatic CCF. Four patients with good patiency through bypass showed significant increase of postoperative cerebral blood flow and good surgical outcome. There was not operative complication except for graft failure of 2 cases.
CONCLUSION
Extracranial to intracranial bypass graft with radial artery or saphenous vein is thought to alternative method for cerebral revascularization in cases with unsuitable STA to bypass, and ICA reconstruction, which acute sacrifice of ICA is necessary.