Browse > Article
http://dx.doi.org/10.3340/jkns.2011.50.3.185

Extracranial-Intracranial Bypass Surgery Using a Radial Artery Interposition Graft for Cerebrovascular Diseases  

Roh, Sung-Woo (Department of Neurological Surgery, University of Ulsan College of Medicine, Asan Medical Center)
Ahn, Jae-Sung (Department of Neurological Surgery, University of Ulsan College of Medicine, Asan Medical Center)
Sung, Han-Yoo (Department of Neurological Surgery, University of Ulsan College of Medicine, Asan Medical Center)
Jung, Young-Jin (Department of Neurological Surgery, University of Ulsan College of Medicine, Asan Medical Center)
Kwun, Byung-Duk (Department of Neurological Surgery, University of Ulsan College of Medicine, Asan Medical Center)
Kim, Chang-Jin (Department of Neurological Surgery, University of Ulsan College of Medicine, Asan Medical Center)
Publication Information
Journal of Korean Neurosurgical Society / v.50, no.3, 2011 , pp. 185-190 More about this Journal
Abstract
Objective : To investigate the efficacy of extracranial-intracranial (EC-IC) bypass surgery using a radial artery interposition graft (RAIG) for surgical management of cerebrovascular diseases. Methods : The study involved a retrospective analysis of 13 patients who underwent EC-IC bypass surgery using RAIG at a single neurosurgical institute between 2003 and 2009. The diseases comprised intracranial aneurysm (n=10), carotid artery occlusive disease (n=2), and delayed stenosis in the donor superficial temporal artery (STA) following previous STA-middle cerebral artery bypass surgery (n=1). Patients were followed clinically and radiographically. Results : Bypass surgery was successful in all patients. At a mean follow-up of 53.4 months, the short-term patency rate was 100%, and the long-term rate was 92.3%. Twelve patients had an excellent clinical outcome of Glasgow Outcome Scale (GOS) 5, and one case had GOS 3. Procedure-related complications were a temporary dysthesia on the graft harvest hand (n=1) and a hematoma at the graft harvest site (n=1), and these were treated successfully with no permanent sequelae. In one case, spasm occurred which was relieved with the introduction of mechanical dilators. Conclusion : EC-IC bypass using a RAIG appears to be an effective treatment for a variety of cerebrovascular diseases requiring proximal occlusion or trapping of the parent artery.
Keywords
EC-IC arterial bypass; Radial artery interposition graft; Revascularization;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
Times Cited By Web Of Science : 0  (Related Records In Web of Science)
Times Cited By SCOPUS : 0
연도 인용수 순위
1 Boop FA, Story JL, Brown WE, Ansell LV : Cerebral revascularization with an artificial graft : long-term follow-up and discussion of the role of graft pretreatment with modified host endothelial cells. Surg Neurol 40 : 155-159, 1993   DOI   ScienceOn
2 Buxton B, Fuller J, Gaer J, Liu JJ, Mee J, Sinclair R, et al. : The radial artery as a bypass graft. Curr Opin Cardiol 11 : 591-598, 1996   DOI   ScienceOn
3 Sundt TM Jr, Piepgras DG, Marsh WR, Fode NC : Saphenous vein bypass grafts for giant aneurysms and intracranial occlusive disease. J Neurosurg 65 : 439-450, 1986   DOI
4 Yoshimoto T, Kamiyama H, Abe H, Takikawa S, Ito T : Proximal clipping and bypass between bilateral vertebral arteries using a radial arterial graft for the treatment of a dissecting aneurysm of the vertebral artery. Surg Neurol 36 : 476-481, 1991   DOI   ScienceOn
5 Sekhar LN, Duff JM, Kalavakonda C, Olding M : Cerebral revascularization using radial artery grafts for the treatment of complex intracranial aneurysms : techniques and outcomes for 17 patients. Neurosurgery 49 : 646-658; discussion 658-659, 2001
6 Sanai N, Zador Z, Lawton MT : Bypass surgery for complex brain aneurysms : an assessment of intracranial-intracranial bypass. Neurosurgery 65 : 670-683; discussion 683, 2009   DOI   ScienceOn
7 Santoro A, Guidetti G, Dazzi M, Cantore G : Long saphenous-vein grafts for extracranial and intracranial internal carotid aneurysms amenable neither to clipping nor to endovascular treatment. J Neurosurg Sci 43 : 237-250; discussion 250-251, 1999
8 Sekhar LN, Bucur SD, Bank WO, Wright DC : Venous and arterial bypass grafts for difficult tumors, aneurysms, and occlusive vascular lesions : evolution of surgical treatment and improved graft results. Neurosurgery 44 : 1207-1223; discussion 1223-1224, 1999
9 Sekhar LN, Kalavakonda C : Cerebral revascularization for aneurysms and tumors. Neurosurgery 50 : 321-331, 2002
10 Sugawara Y, Kikuchi T, Ueda T, Nishizaki M, Nakata S, Mochizuki T, et al. : Usefulness of brain SPECT to evaluate brain tolerance and hemodynamic changes during temporary balloon occlusion test and after permanent carotid occlusion. J Nucl Med 43 : 1616-1623, 2002
11 Sundt TM 3rd, Sundt TM Jr : Principles of preparation of vein bypass grafts to maximize patency. J Neurosurg 66 : 172-180, 1987   DOI
12 Jafar JJ, Russell SM, Woo HH : Treatment of giant intracranial aneurysms with saphenous vein extracranial-to-intracranial bypass grafting : indications, operative technique, and results in 29 patients. Neurosurgery 51 : 138-144; discussion 144-146, 2002   DOI   ScienceOn
13 Jennett B, Bond M : Assessment of outcome after severe brain damage. Lancet 1 : 480-484, 1975
14 Kamiyama H : [Bypass with radial artery graft]. No Shinkei Geka 22 : 911-924, 1994
15 Lawton MT, Hamilton MG, Morcos JJ, Spetzler RF : Revascularization and aneurysm surgery : current techniques, indications, and outcome. Neurosurgery 38 : 83-92; discussion 92-94, 1996   DOI
16 Marhold F, Rosen CL : Novel technique to improve vessel mismatch when using saphenous vein bypass grafts for intracranial revascularization procedures. J Neurosurg 112 : 1227-1231, 2010   DOI   ScienceOn
17 Miller JD, Jawad K, Jennett B : Safety of carotid ligation and its role in the management of intracranial aneurysms. J Neurol Neurosurg Psychiatry 40 : 64-72, 1977   DOI
18 Patel HC, Teo M, Higgins N, Kirkpatrick PJ : High flow extra-cranial to intra-cranial bypass for complex internal carotid aneurysms. Br J Neurosurg 24 : 173-178, 2010   DOI   ScienceOn
19 Origitano TC, al-Mefty O, Leonetti JP, DeMonte F, Reichman OH : Vascular considerations and complications in cranial base surgery. Neurosurgery 35 : 351-362; discussion 362-363, 1994   DOI   ScienceOn
20 Park EK, Ahn JS, Kwon DH, Kwun BD : Result of extracranial-intracranial bypass surgery in the treatment of complex intracranial aneurysms : outcomes in 15 cases. J Korean Neurosurg Soc 44 : 228-233, 2008   DOI
21 Carpentier A, Guermonprez JL, Deloche A, Frechette C, DuBost C : The aorta-to-coronary radial artery bypass graft. A technique avoiding pathological changes in grafts. Ann Thorac Surg 16 : 111-121, 1973   DOI   ScienceOn
22 Chiu CJ : Why do radial artery grafts for aortocoronary bypass fail? A reappraisal. Ann Thorac Surg 22 : 520-523, 1976   DOI   ScienceOn
23 Curtis JJ, Stoney WS, Alford WC Jr, Burrus GR, Thomas CS Jr : Intimal hyperplasia. A cause of radial artery aortocoronary bypass graft failure. Ann Thorac Surg 20 : 628-635, 1975   DOI   ScienceOn
24 Hacein-Bey L, Connolly ES Jr, Duong H, Vang MC, Lazar RM, Marshall RS, et al. : Treatment of inoperable carotid aneurysms with endovascular carotid occlusion after extracranial-intracranial bypass surgery. Neurosurgery 41 : 1225-1231; discussion 1231-1234, 1997   DOI   ScienceOn
25 Houkin K, Ishikawa T, Kuroda S, Abe H : Vascular reconstruction using interposed small vessels. Neurosurgery 43 : 501-505, 1998   DOI   ScienceOn
26 Ausman JI, Nicoloff DM, Chou SN : Posterior fossa revascularization : anastomosis of vertebral artery to PICA with interposed radial artery graft. Surg Neurol 9 : 281-286, 1978
27 Houkin K, Kamiyama H, Kuroda S, Ishikawa T, Takahashi A, Abe H : Long-term patency of radial artery graft bypass for reconstruction of the internal carotid artery. Technical note. J Neurosurg 90 : 786-790, 1999   DOI   ScienceOn
28 Ishikawa T, Kamiyama H, Houkin K, Takahashi A, Iwasaki Y, Abe H : Postsurgical observations of mean hemispheric cerebral blood flow with patients receiving high-flow EC-IC bypass using a radial artery graft (preliminary report, one-year observation of 10 hemispheres). Surg Neurol 43 : 500-506; discussion 506-509, 1995   DOI   ScienceOn
29 Acar C, Jebara VA, Portoghese M, Beyssen B, Pagny JY, Grare P, et al. : Revival of the radial artery for coronary artery bypass grafting. Ann Thorac Surg 54 : 652-659; discussion 659-660, 1992   DOI   ScienceOn
30 Baaj AA, Agazzi S, van Loveren H : Graft selection in cerebral revascularization. Neurosurg Focus 26 : E18, 2009   DOI