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Updated: May 10, 2026
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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Emergency EC-IC bypass for symptomatic atherosclerotic ischemic stroke
Tetsuyoshi Horiuchi1, Junpei Nitta, Shigetoshi Ishizaka
1Department of Neurosurgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan, tetuyosi@shinshu-u.ac.jp.
Neurosurgical Review
|July 4, 2013
Summary
Urgent extracranial-intracranial (EC-IC) bypass surgery can effectively treat acute internal carotid artery or middle cerebral artery stenosis or occlusion. Most patients experienced improved neurological function and favorable outcomes after this intervention.
Area of Science:
- Neurosurgery
- Vascular Neurology
- Cerebrovascular Disease
Background:
- Extracranial-intracranial (EC-IC) bypass surgery's role in acute main trunk stenosis or occlusion remains under investigation.
- Previous research indicated no preventive effect of EC-IC bypass for subsequent ischemic stroke in specific patient groups.
Observation:
- A retrospective review of 58 patients undergoing urgent EC-IC bypass for symptomatic internal carotid artery or middle cerebral artery stenosis/occlusion was conducted.
- Lesions involved the internal carotid artery in 32.8% and the middle cerebral artery in 67.2% of cases.
- No hemorrhagic complications were reported post-surgery.
Findings:
- Sixty-nine percent of patients demonstrated neurological function improvement post-EC-IC bypass.
- A favorable outcome was achieved in 74.1% of patients.
- Insufficient collateral flow and postoperative infarction were linked to unfavorable outcomes.
Implications:
- Urgent EC-IC bypass surgery appears to be an effective treatment for acute symptomatic internal carotid artery or middle cerebral artery stenosis or occlusion.
- Patient selection considering collateral flow and risk of infarction is crucial for optimizing surgical outcomes.
- Further research may refine patient selection criteria for EC-IC bypass in acute cerebrovascular events.
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