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Vertebral Artery to Middle Cerebral Artery Bypass for Flow Augmentation
R. Bram, Z. Almadidy, J. Souter, I. Roskova, FT. Charbel
Language English Country United States
Document type Case Reports, Journal Article
- MeSH
- Carotid Artery, Internal surgery MeSH
- Middle Cerebral Artery diagnostic imaging surgery MeSH
- Vertebral Artery diagnostic imaging surgery MeSH
- Cerebrovascular Disorders * surgery MeSH
- Middle Aged MeSH
- Humans MeSH
- Cerebral Revascularization * methods MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
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.
Department of Neurosurgery University Hospital Brno Brno Czech Republic
Department of Neurosurgery University of Illinois at Chicago Chicago Illinois USA
References provided by Crossref.org
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