Subclavian to middle cerebral artery saphenous vein bypass graft

Spetzler, Robert F.; Rhodes, Robert S.; Roski, Richard A.; Likavec, Matt J.

doi:10.3171/jns.1980.53.4.0465

Cited by 87 publications

(20 citation statements)

References 16 publications

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“…8,12) The treatment options previously reported are aortic arch to carotid interposition graft bypass, subclavian to MCA SVG bypass, axillary to carotid artery bypass, half-collar bypass, and transverse cervical to ECA bypass. 1,6,10) In the present case, we observed moderate plaque formation at the ICA origin during the follow-up period, and speculate that the plaque induced retrograde thrombus propagation. Treatments using either interventional neuroradiology or carotid endarterectomy were also considered for the acute phase.…”

Section: Discussionmentioning

confidence: 72%

“…12) This procedure can be modified in terms of the selection of donor arteries, type of interposition graft, and requirement for upper thoracic exposure, depending on the lesion involved. 1,[3][4][5][6]10,11) We describe a case in which vertebral artery (VA)-ICA bypass was the preferred choice, on the basis of the operative approach and the relatively short length of the graft.…”

Section: Introductionmentioning

confidence: 99%

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“Isolated Carotid Bifurcation” and Vertebral-Carotid Artery Bypass for Common Carotid Artery Occlusion

Kazumata

Asaoka

Yokoyama

et al. 2013

Neurol. Med. Chir.(Tokyo)

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Symptomatic common carotid artery (CCA) occlusion is relatively rare, and requires an elaborate vascular reconstruction procedure with which many neurosurgeons are unfamiliar. We describe a case of CCA occlusion managed by vertebral artery (VA)-internal carotid artery (ICA) saphenous vein interposition graft. An 80-year-old man presented with deterioration of consciousness, transient aphasia, and severe right hemiparesis. Angiography revealed proximal occlusion of the left CCA with concomitant patent ICA. Cerebral blood flow measurement using iodine-123 N-isopropyl-p-iodoamphetamine and single photon emission computed tomography showed corresponding hemodynamic insufficiency of the left hemisphere. The patient underwent a novel revascularization procedure, in which the saphenous vein was used as an interposition graft between the V 3 segment of the VA and the left proximal ICA. Postoperative course was uneventful, and patency of the bypass graft was confirmed. VA-ICA bypass with interposition graft is an alternative treatment option for symptomatic proximal CCA occlusion.

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Section: Discussionmentioning

confidence: 72%

Section: Introductionmentioning

confidence: 99%

“Isolated Carotid Bifurcation” and Vertebral-Carotid Artery Bypass for Common Carotid Artery Occlusion

Kazumata

Asaoka

Yokoyama

et al. 2013

Neurol. Med. Chir.(Tokyo)

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“…13 In the presence of an occluded common carotid artery, long saphenous bypass, such as subclavian MCA bypass, procedures have also been described. [13][14][15] Unfortunately, such procedures carry a higher complication profile and lower patency rate than an arteryartery anastomosis of similar-sized vessels. 14,16,17 In 1978, Ausman et al were the first to describe the technique of salvaging the superficial temporal artery for bypass by first performing a subclavian-external carotid artery bypass, followed 6 weeks later by STA-MCA bypass in a patient with retinal ischemia.…”

Section: Discussionmentioning

confidence: 99%

Staged Cerebral Revascularization in a Patient With an Occluded Common Carotid Artery

Rabb

Moneta

2005

Stroke

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Background and Purpose-We report a management strategy for cerebral revascularization in a patient with an occluded common carotid artery by first performing a subclavian to external carotid artery bypass, followed by superficial temporal artery middle cerebral artery (STA-MCA) bypass. Methods-The patient presented with symptomatic left hemispheric hemodynamic insufficiency, associated with occlusion of the ipsilateral internal and common carotid arteries. The STA was not detectable. The patient was treated initially with a subclavian to external carotid artery bypass, with partial improvement in symptoms. Results-Angiography demonstrated improvement in perfusion and STA filling, which was used for STA-MCA bypass, with resolution of symptoms. Conclusion-Our experience with this case has led us to consider a staged approach for management of patients with an occluded common carotid artery. (Stroke. 2005;36:e68-e70.)

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“…The tolerance of the occipital lobe to temporary posterior cerebral artery occlusion has a major bearing on the feasibility of this operation. The good performance of saphenous veins for carotid system bypass is an additional encouraging consideration (14,16). Intracranial transposition bypass procedures have included side-to-side anastomoses between the posterior cerebral artery and the superior cerebellar artery and end-to-side anastomoses between these two vessels in cases in which a giant aneurysm has been resected from a segment of one of the two vessels (20).…”

Section: Discussionmentioning

confidence: 99%

Bypass and transluminal dilatation procedures for advanced occlusive disease of the posterior circulation

Hc²,

Dg³

et al. 1982

Neurosurg. Rev.

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Differences in the patterns of occlusive vascular disease in the posterior circulation when contrasted with those in the anterior circulation make it necessary that different types of operative procedures be developed for the management of posterior circulation occlusive disease. The vast majority of patients with symptoms of ischaemia in the posterior circulation can be managed medically. The only indications for operation in this system are the progression or continuation of major symptoms in a patient who is on adequate medical therapy and who has angiographically proven major vessel occlusions or stenoses that produce a haemodynamically significant obstruction to flow. Patients who have been accepted for operation have fulfilled these criteria. Five basic procedures have been developed. The number of different procedures attempted emphasizes the difficulty in the management of these patients and obviously relates to the fact that we have found no single procedure that is applicable to all patients or which is totally reliable. These operations have included: 1) occipital to posterior inferior cerebellar artery bypass procedures, 2) superficial temporal artery to proximal superior cerebellar artery or anterior temporal branch of posterior cerebral artery bypass pedicle flaps for basilar artery stenosis, 3) transluminal angioplastic procedures for focal basilar artery stenosis, 4) interposition saphenous vein bypass grafts between the resected stump of the external carotid artery and the proximal posterior cerebral artery at the tentorial notch, and 5) intracranial transposition bypass procedures which have included side-to-side anastomosis between the posterior cerebral artery and superior cerebellar artery. In all 62 patients having been operated on (May, 1981) have been used the various techniques described above. The results and complications will be discussed in detail. Our experience indicates that each of the above operative procedures may have a role in the management of occlusive disease except those operations which use a superficial temporal artery as the donor pedicle.

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Subclavian to middle cerebral artery saphenous vein bypass graft

Cited by 87 publications

References 16 publications

“Isolated Carotid Bifurcation” and Vertebral-Carotid Artery Bypass for Common Carotid Artery Occlusion

“Isolated Carotid Bifurcation” and Vertebral-Carotid Artery Bypass for Common Carotid Artery Occlusion

Staged Cerebral Revascularization in a Patient With an Occluded Common Carotid Artery

Bypass and transluminal dilatation procedures for advanced occlusive disease of the posterior circulation

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