[Results of the first hundred cerebral bypass operations in Basel]

This is a report on clinical findings after 100 extra-intracranial bypass procedures for cerebral ischemia. The patients presented with transient ischemic attacks, prolonged ischemic neurological deficits, completed strokes, low perfusion syndromes and ischemic ocular diseases. The microvascular anastomosis is performed between a branch of the external carotid artery and a cortical branch of the middle cerebral artery. In 10 patients we performed a bilateral bypass. We had no mortality. The morbidity was 5%, the patency rate 96%. The effect of the microvascular procedure can be determined by comparing the postoperative follow-up (averaging 22 months) and the natural course of cerebrovascular disease. Clinical benefit is gained in the elimination of transient ischemic attacks. Patients considered candidates for diagnostic studies are those presenting with completed strokes. Finally in patients with large aneurysms extra-intracranial bypass procedures may prove to be of value, when carried out in a combined approach.