Bypass surgery for vascular disease of the carotid and vertebral artery systems
The authors’ experience with extra- to intracranial arterial bypass (EIAB) surgery for occlusive disease in the carotid system consists of 50 superficial-temporal-artery to middle-cerebral-artery branch (STA-MCA) anastomoses performed in 48 patients over the 5-year period from January 1971 to June 1976. Eight cases were operated between January 1971 and January 1974, and constituted a preliminary experience, the procedure being carried out prior to a time when our methods had been refined, typically in a group of patients with urgent or semiurgent problems, and the surgery representing a desperation effort to reverse cerebral ischemia. Since January 1974, 42 cases comprise our recent experience. We have improved our microsuture technique through hours spent in the laboratory and have adopted a more consistent routine in the procedure itself, following basically the same techniques as described originally by Yasargil(11,12) and Donaghy.(6) However, we now usually expose the cortical middle cerebral branch through a 5-cm trephine positioned approximately 6 cm over the ear as preferred by Chater.(3,4) This usually presents us with a suitable cortical artery for anastomosis.
KeywordsBypass Surgery Vertebral Artery Occipital Artery Transient Ischemic Attack Carotid System
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