Neurosurgical Revascularization for Cerebral Ischemic Disease

  • Living reference work entry
  • First Online:
PanVascular Medicine
  • 248 Accesses

Abstract

The first extracranial-intracranial bypass in human was performed in 1967. After decades and several randomized controlled trials, the clinical role of bypass surgery in patients suffering from cerebral ischemic disease today remains still unclear. First, careful selection of possible candidates, which includes the hemodynamic capacity, is mandatory. Second, if performed in selected cases, a meticulous procedure, which includes the surgery itself step by step as well as the postoperative care, should be guaranteed at dedicated centers with a low perioperative morbidity rate.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

Similar content being viewed by others

Abbreviations

Chronic cerebral ischemia:

Refers to a state where the absolute or relative supply of blood to the brain or specific part of the brain is restricted, often causing symptoms similar to a stroke (i.e. weakness, speech or vision disturbances etc).

Revascularization:

Refers to a type of surgery with the aim to provide more blood supply to the brain by bypassing occluded or highly stenotic arteries to the brain or within the brain.

References

  • Amarenco P et al (2009) Results of the stroke prevention by aggressive reduction in cholesterol levels (SPARCL) trial by stroke subtypes. Stroke 40(4):1405–1409

    Article  PubMed  CAS  Google Scholar 

  • Amin-Hanjani S, Butler WE, Ogilvy CS, Carter BS, Barker FG 2nd (2005) Extracranial-intracranial bypass in the treatment of occlusive cerebrovascular disease and intracranial aneurysms in the United States between 1992 and 2001: a population-based study. J Neurosurg 103(5):794–804

    Article  PubMed  Google Scholar 

  • Amin-Hanjani S, Barker FG 2nd, Charbel FT, Connolly ESJ, Morcos JJ, Thompson BG (2012) Extracranial-intracranial bypass for stroke-is this the end of the line or a bump in the road? Neurosurgery 71(3):557–561

    Article  PubMed  Google Scholar 

  • Ausman JI, Diaz FG (1986) Critique of the extracranial-intracranial bypass study. Surg Neurol 26(3):218–221

    Article  PubMed  CAS  Google Scholar 

  • Chimowitz MI et al (2011) Stenting versus aggressive medical therapy for intracranial arterial stenosis. N Engl J Med 365(11):993–1003

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  • Day AL, Rhoton AL Jr, Little JR (1986) The extracranial-intracranial bypass study. Surg Neurol 26(3):222–226

    Article  PubMed  CAS  Google Scholar 

  • Derdeyn CP, Videen TO, Fritsch SM, Carpenter DA, Grubb RL Jr, Powers WJ (1999) Compensatory mechanisms for chronic cerebral hypoperfusion in patients with carotid occlusion. Stroke 30(5):1019–1024

    Article  PubMed  CAS  Google Scholar 

  • Derdeyn CP et al (2013) Aggressive medical treatment with or without stenting in high-risk patients with intracranial artery stenosis (SAMMPRIS): the final results of a randomised trial. Lancet 383(9914):333–341

    Article  PubMed  Google Scholar 

  • Goldring S, Zervas N, Langfitt T (1987) The Extracranial-Intracranial Bypass Study. A report of the committee appointed by the American Association of Neurological Surgeons to examine the study. N Engl J Med 316(13):817–820

    Article  PubMed  CAS  Google Scholar 

  • Goldstein LB et al (2009) Statin treatment and stroke outcome in the stroke prevention by aggressive reduction in cholesterol levels (SPARCL) trial. Stroke 40(11):3526–3531

    Article  PubMed  CAS  Google Scholar 

  • Grubb RL Jr, Derdeyn CP, Fritsch SM, Carpenter DA, Yundt KD, Videen TO, Spitznagel EL, Powers WJ (1998) Importance of hemodynamic factors in the prognosis of symptomatic carotid occlusion. JAMA 280(12):1055–1060

    Article  PubMed  Google Scholar 

  • Hänggi D, Steiger HJ, Vajkoczy P (2012) EC-IC bypass for stroke: is there a future perspective? Acta Neurochir (Wien) 154(10):1943–1944

    Article  Google Scholar 

  • Ogasawara K, Ogawa A (2006) JET study (Japanese EC-IC Bypass Trial). Nihon Rinsho 64(Suppl 7):524–527

    PubMed  Google Scholar 

  • Powers WJ (1991) Cerebral hemodynamics in ischemic cerebrovascular disease. Ann Neurol 29(3):231–240

    Article  PubMed  CAS  Google Scholar 

  • Powers WJ, Press GA, Grubb RL Jr, Gado M, Raichle ME (1987) The effect of hemodynamically significant carotid artery disease on the hemodynamic status of the cerebral circulation. Ann Intern Med 106(1):27–34

    Article  PubMed  CAS  Google Scholar 

  • Powers WJ, Clarke WR, Grubb RL Jr, Videen TO, Adams HP Jr, Derdeyn CP (2011) Extracranial-intracranial bypass surgery for stroke prevention in hemodynamic cerebral ischemia: the carotid occlusion surgery study randomized trial. JAMA 306(18):1983–1992

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  • Sundt TM Jr (1987) Was the international randomized trial of extracranial-intracranial arterial bypass representative of the population at risk? N Engl J Med 316(13):814–816

    Article  PubMed  Google Scholar 

  • The EC-IC Bypass Study Group (1985) Failure of extracranial-intracranial arterial bypass to reduce the risk of ischemic stroke. Results of an international randomized trial. N Engl J Med 313(19):1191–1200

    Article  Google Scholar 

  • Vorstrup S, Zbornikova V, Sjoholm H, Skoglund L, Ryding E (1992) CBF and transcranial Doppler sonography during vasodilatory stress tests in patients with common carotid artery occlusion. Neurol Res 14(1):31–38

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Daniel Hänggi .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag Berlin Heidelberg

About this entry

Cite this entry

Hänggi, D., Etminan, N. (2014). Neurosurgical Revascularization for Cerebral Ischemic Disease. In: Lanzer, P. (eds) PanVascular Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-37393-0_107-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-37393-0_107-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Online ISBN: 978-3-642-37393-0

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics

Navigation