Current Open Surgical Indications for Revascularization in Cerebral Ischemia

  • Marc Timothy Eastin
  • Vikram Badhri Chakravarthy
  • Fransua Sharafeddin
  • Daniel Hoss
  • Miguel Angel Lopez-GonzalezEmail author
Part of the Acta Neurochirurgica Supplement book series (NEUROCHIRURGICA, volume 127)


Cerebral revascularization was pioneered half a century ago. Gradual improvements in microsurgical instrumentation and training in microsurgical techniques have allowed significant changes that improved outcomes in neurosurgery, extrapolating this knowledge to other neurosurgical diseases (brain tumor, aneurysms, and skull base tumor surgery). But the popularity of cerebral bypass procedures was followed by their decline, given the lack of clear benefit of bypass surgery in chronic cerebrovascular ischemia after the EC-IC bypass studies. Over the last couple of decades, the formidable advance of neuro-endovascular techniques for revascularization has lessened the need for application of open cerebral revascularization procedures, either for flow augmentation or flow replacement. However, there is still a select group of patients with chronic cerebral ischemia, for whom open cerebral revascularization with flow augmentation is the only treatment option available, and this will be the objective of our current review.


Cerebral bypass Cerebral ischemia Revascularization Flow augmentation Flow replacement Vertebrobasilar insufficiency Microsurgery 


Conflict of Interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Marc Timothy Eastin
    • 1
  • Vikram Badhri Chakravarthy
    • 2
  • Fransua Sharafeddin
    • 3
  • Daniel Hoss
    • 4
  • Miguel Angel Lopez-Gonzalez
    • 1
    Email author
  1. 1.Neurosurgery DepartmentSchool of Medicine, Loma Linda UniversityLoma LindaUSA
  2. 2.Neurosurgery DepartmentCleveland Clinic FoundationClevelandUSA
  3. 3.Center for Neuroscience ResearchSchool of Medicine, Loma Linda UniversityLoma LindaUSA
  4. 4.Interventional Neuroradiology DepartmentSchool of Medicine, Loma Linda UniversityLoma LindaUSA

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