Abstract | BACKGROUND: Extracranial-to-intracranial ( EC-IC) arterial bypass is a technically demanding procedure used to treat complex cerebral artery diseases. The indications, proper surgical techniques, and outcomes of this procedure have been under debate over the recent decades. METHODS: Between January 2004 and December 2012, 28 patients, including patients with cerebral artery occlusion, intracranial aneurysm, cranial base tumor, and Moyamoya disease, underwent EC-IC bypass. Patients' records were retrospectively reviewed for demography, indications, complications, high-flow versus low-flow bypass, patency rate of bypass, and neurological outcome. The patients were sorted into prophylactic (n = 16) and therapeutic (n = 12) groups based on the preoperative presentation of their neurological symptoms. Follow-up evaluation was performed at a mean of 32.7 ± 24.3 months. RESULTS: The overall patency rate of bypass was 100%, the postoperative stroke rate was zero, and the surgical complication rate was 14.3%. There was no significant difference in the bypass patency rate between the 2 groups or between the high-flow and low-flow bypass patients. Patients who underwent prophylactic bypass had minimal surgical and total complications (P = 0.03 and P < 0.01, respectively) and a better neurological outcome. Surgical complications were more common in patients who underwent therapeutic bypass (25%). CONCLUSIONS: The collaboration of neurosurgeons and plastic surgeons in performing EC-IC bypass can result in excellent outcomes with a high bypass patency rate and few complications, particularly for prophylactic EC-IC bypass.
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Authors | Emre Gazyakan, Ching-Yi Lee, Chieh-Tsai Wu, Chung-Kan Tsao, Randall Craft, Steven L Henry, Ming-Huei Cheng, Shih-Tseng Lee |
Journal | Plastic and reconstructive surgery. Global open
(Plast Reconstr Surg Glob Open)
Vol. 3
Issue 4
Pg. e372
(Apr 2015)
ISSN: 2169-7574 [Print] United States |
PMID | 25973350
(Publication Type: Journal Article)
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