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Extracranial-intracranial bypass surgery using a radial artery interposition graft for cerebrovascular diseases
Sung Woo Roh1, Jae Sung Ahn, Han Yoo Sung
1Department of Neurological Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Insights
Extracranial-intracranial (EC-IC) bypass surgery with a radial artery interposition graft (RAIG) proved effective for cerebrovascular diseases. The procedure demonstrated high patency and excellent clinical outcomes with minimal complications.
Area of Science:
- Neurosurgery
- Vascular Surgery
- Cerebrovascular Medicine
Background:
- Cerebrovascular diseases pose significant risks requiring effective surgical interventions.
- Extracranial-intracranial (EC-IC) bypass surgery is a critical treatment modality.
- Radial artery interposition grafts (RAIG) offer a potential solution for bypass procedures.
Purpose of the Study:
- To evaluate the efficacy of EC-IC bypass surgery utilizing RAIG.
- To assess RAIG as a surgical management option for various cerebrovascular conditions.
Main Methods:
- Retrospective analysis of 13 patients undergoing EC-IC bypass with RAIG.
- Inclusion of patients with intracranial aneurysms, carotid artery occlusive disease, and superficial temporal artery (STA) stenosis.
- Clinical and radiographic follow-up of all patients.
Main Results:
- Successful bypass surgery in all cases.
- Achieved 100% short-term and 92.3% long-term graft patency.
- 12 patients (excellent outcome GOS 5), 1 patient (GOS 3), with minor, transient complications.
Conclusions:
- EC-IC bypass with RAIG is an effective treatment for cerebrovascular diseases.
- RAIG is a viable option for complex cases requiring proximal artery occlusion or trapping.
Objective:
To investigate the efficacy of extracranial-intracranial (EC-IC) bypass surgery using a radial artery interposition graft (RAIG) for surgical management of cerebrovascular diseases.
Methods:
The study involved a retrospective analysis of 13 patients who underwent EC-IC bypass surgery using RAIG at a single neurosurgical institute between 2003 and 2009. The diseases comprised intracranial aneurysm (n=10), carotid artery occlusive disease (n=2), and delayed stenosis in the donor superficial temporal artery (STA) following previous STA-middle cerebral artery bypass surgery (n=1). Patients were followed clinically and radiographically.
Results:
Bypass surgery was successful in all patients. At a mean follow-up of 53.4 months, the short-term patency rate was 100%, and the long-term rate was 92.3%. Twelve patients had an excellent clinical outcome of Glasgow Outcome Scale (GOS) 5, and one case had GOS 3. Procedure-related complications were a temporary dysthesia on the graft harvest hand (n=1) and a hematoma at the graft harvest site (n=1), and these were treated successfully with no permanent sequelae. In one case, spasm occurred which was relieved with the introduction of mechanical dilators.
Conclusion:
EC-IC bypass using a RAIG appears to be an effective treatment for a variety of cerebrovascular diseases requiring proximal occlusion or trapping of the parent artery.
