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Updated: Aug 10, 2026
Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment
Published on: September 25, 2009
Microsurgical vascular bypass for occlusive cerebrovascular disease; review of 100 cases
Insights
Microvascular arterial bypass surgery shows promising results for treating ischemic cerebrovascular disease, especially for transient ischemic attacks (TIA) previously deemed inoperable. This surgical technique offers a low morbidity rate and high patency, with a 6% stroke incidence post-surgery.
Area of Science:
- Neurosurgery
- Vascular Surgery
- Cerebrovascular Disease
Background:
- Occlusive ischemic cerebrovascular disease poses significant risks, often involving lesions inaccessible to conventional surgery.
- Transient ischemic attacks (TIA) indicate a high risk of subsequent stroke.
Purpose of the Study:
- To evaluate the efficacy and safety of microvascular arterial bypass surgery for cerebrovascular disease.
- To assess outcomes in patients with TIA and hemodynamically significant lesions.
Main Methods:
- Retrospective analysis of 100 consecutive patients undergoing microvascular arterial bypass surgery.
- Assessment of operative mortality, permanent morbidity, and postoperative bypass patency.
Main Results:
- Encouraging outcomes in TIA patients with previously inoperable lesions.
- Low permanent morbidity rate and acceptable operative mortality.
- High postoperative bypass patency rates and a 6% incidence of postoperative stroke in TIA patients.
Conclusions:
- Microvascular arterial bypass surgery is a viable and effective treatment for selected patients with ischemic cerebrovascular disease.
- The procedure demonstrates favorable safety and efficacy profiles, including for complex TIA cases.
Abstract:
This is a report on a series of 100 consecutive patients who had undergone microvascular arterial bypass surgery as an aid in the treatment of occlusive ischemic cerebrovascular disease. The results to date are encouraging in cases of transient ischemic attacks (TIA) with significant hemodynamic vascular lesions previously considered inaccessible or inoperable by conventional vascular surgical techniques. The permanent morbidity rate is low. The operative mortality rate is acceptable. Postoperative patency rates of the surgical bypass remain high. In analyzing the cases presenting with TIA, the total incidence postoperatively to stroke is 6% in the series to date. The average postoperative follow-up is 20 months.
