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  • Urgent EC-IC Bypass for Symptomatic Atherosclerotic Ischemic Stroke

    Final Number:
    132

    Authors:
    Tetsuyoshi Horiuchi MD; Kazuhiro Hongo MD; Junpei Nitta

    Study Design:
    Clinical Trial

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2012 Annual Meeting

    Introduction: Previous studies have shown that extracranial-intracranial (EC-IC) bypass surgery has no preventive effect of subsequent ipsilateral ischemic stroke in patients with symptomatic atherosclerotic internal carotid occlusion and hemodynamic cerebral ischemia. However, few studies have assessed whether an urgent EC-IC bypass surgery is an effective treatment for main trunk stenosis or occlusion in acute stage.

    Methods: The authors retrospectively reviewed 58 consecutive patients who underwent urgent EC-IC bypass for symptomatic stenosis or occlusion at internal carotid artery or middle cerebral artery between January 2003 and December 2011. Clinical characteristics and neuroimagings were evaluated and analyzed.

    Results: Based on preoperative angiogram, the responsible lesions were internal carotid artery in 19 (32.8%) patients and middle cerebral artery in 39 (67.2%). No hemorrhagic complication occurred. Sixty nine percent of patients showed an improvement of neurological function after surgery and 74.1% of patients had favorable outcome. Unfavorable outcome was associated with insufficient collateral flow and new infarction after bypass surgery.

    Conclusions: Although EC-IC anastomosis for acute ischemic stroke is still debatable, it may be a good option for medication-resistance stenoocclusive disease.

    Patient Care: Since urgent EC-IC bypass is effective in patients with stenoocclusive disease, some patients will have some benefits.

    Learning Objectives: By the conclusion of this session, participants should be able to identify one of useful treatments in patients with stenoocclusive disease.

    References:

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