The first experience of extracranial-intracranial high-flow bypasses for treatment of patients with ischemic stroke because of occlusion of internal carotid artery

Objective: the usage of extracranial-intracranial (EC-IC) high-flow bypasses for treatment of patients with ischemic strokes because of unilateral or bilateral occlusion of internal carotid artery (ICA). Material and methods. We performed EC-IC high-flow bypass at 9 patients suffered from ischemic strokes because of ICA occlusion from 01.11.2012 till 30.06. The unilateral ICA occlusion combined with stenosis of contralateral ICA was revealed at 6 patients, bilateral ICA occlusion - 2 patients and 1 patient had occlusion of common carotid artery (CCA) and stenosis of contralateral ICA. Results. All patients suffered from maximum 3 episodes of ischemic stroke at the site of ICA occlusion. The computer tomography (CT) of brain revealed no severe cicatrical and atrophic changes. The bypass was performed between M2 segment of middle cerebral artery (MCA) and external carotid artery (ECA) or CCA. All operations were scheduled and performed by two surgical teams. The radial artery was used as autograft at 8 patients and femoral vein - at 1 patient. The patency of bypass was checked at all patients in postoperative period using Doppler ultrasound and duplex scanning of bypass. The bypass was patent at 5 patients and bypass thrombosis was determined at 4 patients. Conclusion. The usage of EC-IC high-flow bypass may be occurred the promising technique for cerebral hemodynamics improvement in case of ICA occlusion and requires further investigations.

Двусторонняя окклюзия ВСА, широкопросветный экстра-интракраниальный анастомоз, bilateral occlusion of ICA, extracranial-intracranial high-flow bypass

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