Bypass surgery using a radial artery graft for bilateral extracranial carotid arteries occlusion.
A patient presenting with recurrent ischemic attacks was demonstrated to have complete occlusion of the right common and left internal carotid arteries. An external carotid angiogram showed a large left superficial temporal artery (STA) supplying both sides of the scalp. 123I-IMP single photon emission computed tomography (SPECT) revealed hypoperfusion of the both hemispheres, especially the left cerebral hemisphere. An extracranial-intracranial (EC-IC) bypass was performed using a radial artery graft interpositioned between the proximal part of the STA and the M2 segment, thus preserving blood flow to the scalp through the STA. Postoperative angiography after 1 year showed good circulation through the anastomosis, and 123I-IMP SPECT studies demonstrated increased cerebral perfusion. The patient improved clinically. The surgical technique is described below.
Tachibana
E
E
Department of Neurosurgery, Nagoya University School of Medicine, Showa, Japan.
Suzuki
Y
Y
Harada
T
T
Saito
K
K
Gupta
S K
SK
Yoshida
J
J
D002340:Carotid Artery Diseases / Q000150:complications / Q000473:pathology / Q000601:surgery*; D016893:Carotid Stenosis / Q000150:complications / Q000473:pathology / Q000601:surgery*; D002533:Cerebral Angiography; D002544:Cerebral Infarction / Q000209:etiology / Q000473:pathology / Q000601:surgery; D002548:Cerebral Revascularization; D002560:Cerebrovascular Circulation; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D017534:Radial Artery / Q000637:transplantation*; D013699:Temporal Arteries / Q000601:surgery; D015899:Tomography, Emission-Computed, Single-Photon; D014182:Transplantation, Autologous