title: Prediction of flow augmentation and complications of extracranial-intracranial bypass in symptomatic cerebrovascular diseases.
abstract: Augmentation of the cerebral blood supply to correct cerebral hemodynamic insufficiency by extracranial-intracranial bypass may be an appropriate method to reduce the risk of ischemic stroke. Eighty-five patients with ischemic symptoms, decreased regional cerebral blood flow, and decreased regional cerebrovascular reactivity were recruited for surgery. The post-bypass mean regional blood flow increased by 35.8% compared to the pre-bypass value (p<0.001). Only minor re-establishment of vasculature after anastomosis was detected in three of four patients with middle cerebral artery stenosis, which suggests that there are fewer benefits of bypass surgery in this situation. Cerebral infarction occurred immediately post-operation in one patient who was predisposed to stroke due to a bilateral carotid occlusion. Hyperperfusion injury was infrequent in this series; only one patient developed intracerebral hemorrhage three weeks after the bypass. One ischemic and one hemorrhagic stroke occurred during the 90 months following surgery.
authors.affiliation: Department of Neurosurgery and Neuro-Medical Scientific Center, Buddhist Tzu-Chi General Hospital, 707, Section 3, Chung-Yang Road, Hualien 97004, Taiwan. Poluschiou@gmail.com
authors.forename: Tsung-Lang
authors.initials: TL
authors.lastname: Chiu
authors.forename: Sheng-Tzung
authors.initials: ST
authors.lastname: Tsai
authors.forename: Cheng-Hui
authors.initials: CH
authors.lastname: Chiu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015901:Angiography, Digital Subtraction; D002533:Cerebral Angiography; D002548:Cerebral Revascularization / Q000009:adverse effects*; D002561:Cerebrovascular Disorders / Q000601:surgery*; D003545:Cysteine / Q000031:analogs & derivatives; D005260:Female; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology; D011237:Predictive Value of Tests; D012039:Regional Blood Flow / Q000502:physiology; D012189:Retrospective Studies; D013624:Taiwan; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D015609:Organotechnetium Compounds; C059659:technetium Tc 99m bicisate; D003545:Cysteine