title: Spontaneous recanalization of occluded standard extracranial-intracranial arterial bypass.
abstract: 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.
authors.affiliation: Department of Neuroradiology, University Hospital of Mannheim, Faculty for Medicine of the University of Heidelberg, Mannheim, Germany. johann.scharf@rad.ma.uni-heidelberg.de
authors.forename: Johann
authors.initials: J
authors.lastname: Scharf
authors.forename: Peter
authors.initials: P
authors.lastname: Schmiedek
authors.forename: Andre
authors.initials: A
authors.lastname: Kemmling
authors.forename: Lars
authors.initials: L
authors.lastname: Gerigk
authors.forename: Christoph
authors.initials: C
authors.lastname: Groden
authors.forename: Peter
authors.initials: P
authors.lastname: Horn
mesh_terms: 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