Postsurgical observations of mean hemispheric cerebral blood flow with patients receiving high-flow EC-IC bypass using a radial artery graft (preliminary report, one-year observation of 10 hemispheres).
BACKGROUND
When we encounter an inaccessible internal carotid artery lesion, we sacrifice the inaccessible internal carotid artery and, at the same time, establish a high-flow extracranial-to-intracranial arterial bypass (EC-IC bypass). Questions and concerns remain, however, about the dynamics of the patient's cerebral blood flow postoperatively.


METHODS
Ten hemispheres from 9 patients had received radial artery grafting as an EC-IC bypass with the simultaneous obstruction of the internal carotid artery. Their mean hemispheric cerebral blood flow (mCBF) was measured longitudinally during 1 year after surgery by single photon emission computed tomography (SPECT) and a 133Xenon-inhalation method.


RESULTS
The serial mCBF values of the five hemispheres with giant aneurysm or paracavernous meningioma were attenuated during the postoperative 3-month period and then returned to the normal range. In only one case did the postoperative reduction of mCBF fail to return to normal; in addition there was a memory disturbance that had developed and progressed. Five hemispheres with the ICA stenosis did not present reduction in mCBF. In three out of five hemispheres, transient elevation of mCBF at 1 month after surgery was observed.
Ishikawa
T
T
Department of Neurosurgery, Hokkaido University School of Medicine, Sapporo, Japan.
Kamiyama
H
H
Houkin
K
K
Takahashi
A
A
Iwasaki
Y
Y
Abe
H
H
D000368:Aged; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000601:surgery*; D002548:Cerebral Revascularization / Q000379:methods*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017534:Radial Artery / Q000000981:diagnostic imaging / Q000637:transplantation*; D015899:Tomography, Emission-Computed, Single-Photon