Informace o publikaci

Vertebral Artery to Middle Cerebral Artery Bypass for Flow Augmentation

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BRAM Richard ALMADIDY Zayed SOUTER John ROŠKOVÁ Ivana CHARBEL Fady T

Rok publikování 2024
Druh Článek v odborném periodiku
Časopis / Zdroj Operative Neurosurgery
Fakulta / Pracoviště MU

Lékařská fakulta

Citace
www https://journals.lww.com/onsonline/fulltext/9900/vertebral_artery_to_middle_cerebral_artery_bypass.932.aspx
Doi http://dx.doi.org/10.1227/ons.0000000000000942
Klíčová slova Cerebral revascularization; Extracranial intracranial arterial bypass; Interpositional bypass; Vertebral artery
Popis 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.

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