Aortocarotid bypass for hemispheric hypoperfusion in a child.
Large-vessel vasculitis syndromes in the pediatric population are rare and highly morbid. The authors here report on the microsurgical revascularization of a unique case of presumed vasculitis with aortitis and severe obliterative arteriopathy in a 10-month-old child with symptomatic hemispheric hypoperfusion. Using a cryopreserved saphenous vein, this unilateral aortocarotid bypass restored normal intracranial perfusion bilaterally and led to a resolution of the patient's ischemic symptoms. The aortocarotid bypass is clinically effective and technically feasible in young children when a saphenous vein allograft is used. The bypass graft is amenable to angioplasty with or without stenting if delayed stenosis becomes an issue later in life.
Sanai
Nader
N
Department of Neurological Surgery, University of California at San Francisco, California 94143-0112, USA.
Fullerton
Heather
H
Karl
Tom R
TR
Lawton
Michael T
MT
D001011:Aorta / Q000601:surgery*; D001025:Aortitis / Q000601:surgery*; D002545:Brain Ischemia / Q000601:surgery*; D017536:Carotid Artery, Common / Q000601:surgery*; D002533:Cerebral Angiography; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008866:Microsurgery / Q000379:methods; D016491:Peripheral Vascular Diseases / Q000601:surgery*; D012501:Saphenous Vein / Q000637:transplantation; D014184:Transplantation, Homologous