Clinical experience with extra-intracranial arterial anastomosis in 65 cases

Clinical results of an extra-intracranial arterial bypass (EIAB) procedure for cerebral ischemia are assessed in 65 patients. The 5-year-study suggests that the EIAB procedure has a protective effect against further clinically significant cerebrovascular accidents in properly selected patients. Correlation with angiography and regional cerebral blood flow (rCBF) studies are discussed. It is felt that rCBF measurements offer the best diagnostic test to determine which patients are suitable for surgery by revealing if an ischemic or relative ischemic focus is present. The surgical procedure is contraindicated in acute cerebral ischemia and when the rCBF study reveals general reduction of cerebral blood flow as opposed to a localized ischemic focus.