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Long term outcome of transcranial bypass
1Professorial Surgical Unit, St Bartholomew's Hospital, London EC1A 7BE, UK. paul.srodon@bartsandthelondon.nhs.uk
Objectives:
This study examines the long term outcome of transcranial bypass in a single centre.
Methods:
In a prospective study, symptoms and angiographic findings were recoded on a database for 229 consecutive transcranial bypass procedures performed in 204 patients between 1976 and 1983. One hundred and seventy-seven had carotid territory symptoms, and the predominant angiogram finding was internal carotid artery (ICA) occlusion.
Results:
At 5 years 87% (86 patients) were free from stroke. At 20 years 83% (29 patients) were stroke free but by this time the majority had died from other cardiovascular causes and 35 were lost to follow up.
Conclusion:
Stroke is uncommon five or more years after transcranial bypass but overall survival is poor.