Spontaneous recanalization of occluded standard extracranial-intracranial arterial bypass.
BACKGROUND
In the event of early failure of standard extracranial-intracranial arterial bypass, elective but prompt revision surgery is generally attempted under the assumption that early occlusion is permanent. However, little is known about the occurrence of spontaneous revascularization.


OBJECTIVE
To estimate the frequency and time course of spontaneous recanalization in primary extracranial-intracranial arterial bypass occlusion and re-evaluate diagnostic and therapeutic options facing spontaneous development.


RESULTS
In a retrospective analysis 176 patients with standard superficial temporal artery/middle cerebral artery bypass were included. Twenty-three patients had primary bypass occlusion. In 7 cases spontaneous recanalization was observed. Follow-up of these cases is presented.


CONCLUSIONS
Early bypass occlusion has a high incidence of spontaneous recanalization within the first year. In stable patients the first choice may be noninvasive follow-up and postponing revision operation.
Scharf
Johann
J
Department of Neuroradiology, University Hospital of Mannheim, Faculty for Medicine of the University of Heidelberg, Mannheim, Germany. johann.scharf@rad.ma.uni-heidelberg.de
Schmiedek
Peter
P
Kemmling
Andre
A
Gerigk
Lars
L
Groden
Christoph
C
Horn
Peter
P
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D002533:Cerebral Angiography; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D020767:Intracranial Thrombosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D018579:Patient Selection; D012075:Remission, Spontaneous; D012086:Reoperation; D012189:Retrospective Studies; D013699:Temporal Arteries / Q000000981:diagnostic imaging / Q000601:surgery*; D013997:Time Factors; D014654:Vascular Patency