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Indexed/Abstracted in: e-psyche, EMBASE, PubMed/MEDLINE, Neuroscience Citation Index, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,651
Online ISSN 1827-1855
Galkin P., Gushcha A., Chechetkin A., Krotenkova I.
Research Center of Neurology, Moscow, Russian Federation
AIM: To evaluate the efficacy of interposed saphenous vein graft (SVG) usage during extracranial-intracranial (EC-IC) bypass surgery in patients with cerebral ischemia and appropriate donor artery absence.
PATIENTS AND METHODS: Since October 2010 till January 2014 62 EC-IC bypass surgeries were applied in 60 patients. In nineteen patients SVG was used to create low-flow bypasses between superficial temporal artery trunk and cortical segment of middle cerebral artery. SVG was used due to inappropriate diameter of scalp artery in 12 cases, inadequate flow in intended donor artery in 5 patients and in 2 cases – for other reasons. Indications for revascularization were based on clinical symptoms of cerebral haemodynamics impairment, confirmed with transcranial duplex ultrasonography (DUS) and brain perfusion computed tomography (CT).
RESULTS: early bypass potency was confirmed with DUS up to 9 postoperative day in 16 patients. In 3 (15,8%) patients blood flow wasn’t visualized. Bypass patency in these patients was confirmed with repeated DUS up to 42 months period. At mean clinical follow-up of 22.3 months 14 patients (73,7%) reported an improvement of their condition, 4 patients (21%) didn’t observe any changes in well-being and 1 patient (5,3%) got worse. Late bypass patency assessment was available and confirmed in 16 patients at mean follow-up of 15.6 months post operation. Repeated brain perfusion CT was performed in 10 patients at mean follow-up of 5.2 months. Average growth of regional cerebral blood flow was 24.1%.
CONCLUSION: Use of interposed SVG bypass for EC-IC revascularization is an effective method, that could be applied in patients with cerebral ischemia caused by internal carotid artery occlusive disease and absence of appropriate donor artery.