Non-invasive evaluation of patients with extracranial to intracranial bypass

In selected patients with cerebrovascular insufficiency, an extracranial-intracranial bypass is indicated to increase cerebral blood flow. To assess the effect of this operation upon routine non-invasive testing, 15 patients had oculoplethysmography, carotid phonoangiography and Doppler testing. None of those with a preoperative abnormality were changed after surgery, despite angiographically proven anastomotic patency. Whereas non-invasive tests may correctly identify severe internal carotid stenosis, use of these modalities in their routine form does not predict extracranial-intracranial bypass patency.