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Revascularization of the posterior circulation.
Bert A Coert1, Steven D Chang, Michael P Marks
1Department of Neurosurgery, Stanford University School of Medicine, Stanford, California 94304-5327, USA.
Summary
Revascularization of the posterior circulation prevents vertebrobasilar ischemic stroke. Procedures like bypasses and angioplasty offer symptom relief and reduce stroke risk with low complications.
Area of Science:
- Neurosurgery
- Vascular Neurology
- Cerebrovascular Disease
Background:
- Posterior circulation revascularization aims to prevent vertebrobasilar ischemic stroke.
- Posterior communicating artery size influences ischemia susceptibility.
- Indications include refractory symptomatic ischemia and parent vessel occlusion.
Purpose of the Study:
- To summarize revascularization strategies for posterior circulation ischemia.
- To review treatment options and outcomes.
Main Methods:
- Review of endovascular and surgical revascularization techniques.
- Discussion of pretreatment assessments like cerebral blood flow.
- Emphasis on neuroprotective measures and intraoperative monitoring.
Main Results:
- Various bypass grafts (e.g., superficial temporal artery) can augment posterior circulation.
- Reported symptom improvement in 60-100% of patients.
- Associated with reduced stroke risk and low complication rates.
Conclusions:
- Revascularization is effective in preventing posterior circulation ischemic stroke.
- Multiple surgical and endovascular options exist.
- Careful patient selection and management optimize outcomes.