Place of the extra-intra-cranial-bypass in aneurysm-surgery.
Before the use of the EC/IC-bypass, despite several tests to predict complications, ligation of the i.c.a. (e.g. in treatment of an unclippable aneurysm) offered a significant risk of cerebral ischemia, either acutely or on long term. In this article the hemodynamic background of the EC/IC-bypass as well as its probable effect on local cerebral blood flow are discussed. Next, a series of 26 patients is presented in which ligation of the i.c.a or the m.c.a. was considered. To prevent cerebral ischemia, first an EC/IC-bypass was established. After all, in 15 patients ligation of the i.c.a. was necessary. Beside one major complication the other complications after ligation were only minor and temporary.
de Jong
T H
TH
Department of Neurosurgery, State University Hospital, Utrecht, The Netherlands.
Tulleken
C A
CA
Ramos
L
L
D000328:Adult; D000368:Aged; D002340:Carotid Artery Diseases / Q000601:surgery; D002343:Carotid Artery, Internal / Q000601:surgery; D002548:Cerebral Revascularization; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D008297:Male; D008875:Middle Aged