Abstract
Background:Extracranial-intracranial bypass operation is an essential procedure for cerebrovascular surgeons. Proper procedure of the bypass requires special skills, selected instruments, and training in the microsurgical laboratory. In spite of the high success rate for extracranial-intracranial bypass, a potential pitfall while performing an end-to-side anastomosis is poor blood flow or occlusion at the anastomotic site during surgery. If this happens, revision procedure is necessary.Methods:We introduce our salvage techniques for anastomosis revision with or without recipient artery occlusion.Results:With this method, ischemic complication related to revision procedure minimizes ischemic complications.Conclusions:The present technique is a simple method for anastomosis revision.
Highlights
Extracranial-intracranial bypass operation is an essential procedure for cerebrovascular surgeons
Superficial temporal artery-middle cerebral artery (STAMCA) bypass has been used in the management of selected atherosclerotic cerebrovascular occlusive disease, moyamoya disease, artery involved tumors, and unclippable aneurysms.[1,2,3,4,5,6]
The success rate for STA-MCA bypass is high, immediate donor occlusion occurs in a small number of patients and anastomosis revision is necessary in such cases
Summary
Extracranial-intracranial bypass operation is an essential procedure for cerebrovascular surgeons. The success rate for STA-MCA bypass is high, immediate donor occlusion occurs in a small number of patients and anastomosis revision is necessary in such cases. If immediate occlusion of the donor artery at bypass site is seen, surgeons usually reopen and revise the anastomosis [Figure 1a].[1] this simple technique achieves the patency of bypass flow in almost all cases, it does not work in a few cases and might result in recipient occlusion because surgical manipulation causes the endothelial injury of recipient artery. We introduce salvage techniques if immediate occlusion happens at the end‐to‐side anastomotic site.
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