Biomaterial Database

Revascularization of cerebral ischemia after previous bilateral extracranial-intracranial bypass procedures. 1997

V S Sottiurai, and L Herbert, and D Hatter

Department of Surgery, Louisiana State University School of Medicine, New Orleans 70112-2822, USA.

Extracranial-intracranial (EC-IC) bypass grafting procedures were specially designed for treatment of bilateral internal carotid artery occlusion. When performed in an expeditious manner, EC-IC bypass procedures have produced effective and durable results, despite the recent disfavor given to this procedure. This communication reports a 68-year-old white man who developed generalized cerebral ischemia manifested as confusion, incoherence, disorientation, ataxia, and numerous episodes of syncope daily. A cerebral angiogram revealed bilateral external carotid arteries and left solitary vertebral artery critical stenosis. Transcranial Doppler study demonstrated reduction of cerebral and vertebral-basilar perfusion. However, the patient's EC-IC bypass graft had remained patent since 1985. The patient's recurrent symptoms of global ischemia and syncope resolved after carotid endarterectomy, vein patch external carotid artery, and vertebral-to-common carotid artery transposition. This report reiterates the value of the EC-IC bypass procedure and presents the surgical management of symptomatic external carotid and vertebral artery stenosis in patients after EC-IC bypass procedures.

UI	MeSH Term	Description	Entries
D008297	Male		Males
D012086	Reoperation	A repeat operation for the same condition in the same patient due to disease progression or recurrence, or as followup to failed previous surgery.	Revision, Joint,Revision, Surgical,Surgery, Repeat,Surgical Revision,Repeat Surgery,Revision Surgery,Joint Revision,Revision Surgeries,Surgery, Revision
D002533	Cerebral Angiography	Radiography of the vascular system of the brain after injection of a contrast medium.	Angiography, Cerebral,Angiographies, Cerebral,Cerebral Angiographies
D002545	Brain Ischemia	Localized reduction of blood flow to brain tissue due to arterial obstruction or systemic hypoperfusion. This frequently occurs in conjunction with brain hypoxia (HYPOXIA, BRAIN). Prolonged ischemia is associated with BRAIN INFARCTION.	Cerebral Ischemia,Ischemic Encephalopathy,Encephalopathy, Ischemic,Ischemia, Cerebral,Brain Ischemias,Cerebral Ischemias,Ischemia, Brain,Ischemias, Cerebral,Ischemic Encephalopathies
D002548	Cerebral Revascularization	Microsurgical revascularization to improve intracranial circulation. It usually involves joining the extracranial circulation to the intracranial circulation but may include extracranial revascularization (e.g., subclavian-vertebral artery bypass, subclavian-external carotid artery bypass). It is performed by joining two arteries (direct anastomosis or use of graft) or by free autologous transplantation of highly vascularized tissue to the surface of the brain.	Brain Revascularization,EC-IC Arterial Bypass,Extracranial-Intracranial Arterial Bypass,Microsurgical Revascularization, Cerebral,STA-MCA Bypass,Cerebral Microsurgical Revascularization,Arterial Bypass, EC-IC,Arterial Bypass, Extracranial-Intracranial,Arterial Bypasses, EC-IC,Arterial Bypasses, Extracranial-Intracranial,Bypass, EC-IC Arterial,Bypass, Extracranial-Intracranial Arterial,Bypass, STA-MCA,Bypasses, EC-IC Arterial,Bypasses, Extracranial-Intracranial Arterial,Bypasses, STA-MCA,Cerebral Microsurgical Revascularizations,EC IC Arterial Bypass,EC-IC Arterial Bypasses,Extracranial Intracranial Arterial Bypass,Extracranial-Intracranial Arterial Bypasses,Revascularization, Brain,Revascularization, Cerebral,Revascularization, Cerebral Microsurgical,STA MCA Bypass,STA-MCA Bypasses
D003251	Constriction, Pathologic	The condition of an anatomical structure's being constricted beyond normal dimensions.	Stenosis,Stricture,Constriction, Pathological,Pathologic Constriction,Constrictions, Pathologic,Pathologic Constrictions,Pathological Constriction,Stenoses,Strictures
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368	Aged	A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available.	Elderly
D014711	Vertebral Artery	The first branch of the SUBCLAVIAN ARTERY with distribution to muscles of the NECK; VERTEBRAE; SPINAL CORD; CEREBELLUM; and interior of the CEREBRUM.	Vertebral Arteries,Arteries, Vertebral,Artery, Vertebral
D016893	Carotid Stenosis	Narrowing or stricture of any part of the CAROTID ARTERIES, most often due to atherosclerotic plaque formation. Ulcerations may form in atherosclerotic plaques and induce THROMBUS formation. Platelet or cholesterol emboli may arise from stenotic carotid lesions and induce a TRANSIENT ISCHEMIC ATTACK; CEREBROVASCULAR ACCIDENT; or temporary blindness (AMAUROSIS FUGAX). (From Adams et al., Principles of Neurology, 6th ed, pp 822-3)	Carotid Artery Narrowing,Carotid Ulcer,Carotid Artery Plaque,Carotid Artery Stenosis,Carotid Artery Ulcerating Plaque,Common Carotid Artery Stenosis,External Carotid Artery Stenosis,Internal Carotid Artery Stenosis,Plaque, Ulcerating, Carotid Artery,Stenosis, Common Carotid Artery,Stenosis, External Carotid Artery,Ulcerating Plaque, Carotid Artery,Artery Narrowing, Carotid,Artery Narrowings, Carotid,Artery Plaque, Carotid,Artery Plaques, Carotid,Artery Stenoses, Carotid,Artery Stenosis, Carotid,Carotid Artery Narrowings,Carotid Artery Plaques,Carotid Artery Stenoses,Carotid Stenoses,Carotid Ulcers,Narrowing, Carotid Artery,Narrowings, Carotid Artery,Plaque, Carotid Artery,Plaques, Carotid Artery,Stenoses, Carotid,Stenoses, Carotid Artery,Stenosis, Carotid,Stenosis, Carotid Artery,Ulcer, Carotid,Ulcers, Carotid