Navigation Links
University Hospitals Case Medical Center neurosurgeons champion brain bypass in select patients
Date:11/7/2011

CLEVELAND A microsurgical procedure that has lost some ground to advances in endovascular therapy still plays a critical role in the management of selected neurovascular disorders, according to a University Hospitals Case Medical Center neurosurgeon who performs the procedure.

"Though its indications are rare, the ability to perform brain bypass correctly can make all the difference for certain patients who have complex brain aneurysms or other cerebrovascular disorders," said Nicholas C. Bambakidis, MD, Director, Cerebrovascular and Skull Base Surgery, University Hospitals (UH) Neurological Institute, UH Case Medical Center, and Associate Professor, Neurological Surgery, Case Western Reserve University School of Medicine.

Brain bypass, also known as extracranial to intracranial (EC-IC) bypass, was first performed successfully in 1967 to treat a blocked internal carotid artery. The procedure involves connecting the external carotid artery to the internal carotid artery, either directly or by grafting a vein or artery. The choice of graft depends on the size of the recipient and donor vessels, graft availability and the extent of required blood flow augmentation. In a Journal of NeuroInterventional Surgery article (2010;2:229-236) discussing the current role of cerebral revascularization for ischemic disease, Dr. Bambakidis and co-author Shakeel Chowdhry, MD, Neurological Institute, UH Case Medical Center, Resident, Department of Neurological Surgery, Case Western Reserve University School of Medicine, note that the procedure was originally envisioned as a treatment option for cerebrovascular occlusive and ischemic disease, but is now rarely used for these indications.

"As newer, minimally invasive technology has come online in vascular treatment, the pendulum swings toward avoidance of surgical treatment at all costs," said Dr. Bambakidis. "As a result, many centers are doing endovascular treatment of aneurysms, but fewer are doing brain bypass procedures. In a sense, it's almost becoming a lost art. The expertise is becoming more and more concentrated in larger centers."

While an endovascular procedure is the optimal treatment for many brain aneurysms, in select cases, endovascular treatment poses a higher risk of stroke than brain bypass, Dr. Bambakidis said. "There are certain brain aneurysms that simply can't close without the sacrifice of some normal blood vessels," he explained. "The EC-IC bypass is designed to bypass the aneurysm and provide blood to those vessels which you would otherwise have to close off, and having that blood supply reduces the risk of stroke."

Complex giant aneurysms (greater than 2.5 cm) are the main indication for brain bypass, although Dr. Bambakidis recently performed the procedure on a young patient with a smaller aneurysm. "This was a 14-year-old boy with a 2-cm aneurysm; we did the bypass using a radial artery from his wrist," he noted. "Aneurysms in younger people are rare, but when we do see them they tend to be these larger ones that often require some kind of bypass or complicated open surgery." He added that although brain bypass is not typically indicated for ischemic brain stroke, it is a critical treatment modality for certain young patients with vascular insufficiency and resultant ischemic or hemorrhagic strokes.

"These patients, who often have a disease called moyamoya syndrome, can have their symptoms improve dramatically after surgery," Dr. Bambakidis said.

New technology such as fluorescent videoangiography is making brain bypass easier and safer, Dr. Bambakidis said, but it is still a delicate procedure that's difficult to perform well. "Multidisciplinary expertise and coordination of care between neuroradiologists and neurosurgeons is critical to achieving an optimal result for the patient," he said. "Because we're known as a center that offers this expertise, our patients come from areas far beyond Greater Cleveland to undergo the brain bypass procedure."


'/>"/>

Contact: George Stamatis
george.stamatis@uhhospitals.org
216-844-3667
University Hospitals Case Medical Center
Source:Eurekalert

Related medicine news :

1. Michigan State University tackles health needs of an aging statewide population
2. Virginia Commonwealth University findings may help explain high blood pressure in pregnancy
3. Thomas Jefferson University Hospital cuts Whipple procedure wound infections in half with new measures
4. FDA awards Georgetown University a Center of Excellence in Regulatory Science & Innovation
5. University of Michigan announces Eric J. Topol Professorship in Cardiovascular Medicine
6. Wayne State University study of heroin users to examine links between stress, drug use
7. University of Missouri program helps teachers prevent teen suicides
8. Hebrew University researchers show how motherhood alters brain function
9. Louisiana Tech University recognizes innovators, inventors
10. Thomas Jefferson University Hospital adopts new imaging agent to improve detection of bladder cancer
11. University of Delaware to lead DoD orthopaedic rehabilitation consortium
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:4/26/2017)... , ... April 26, 2017 , ... ... in Hackensack, N.J. has been honored by Enterprising Women magazine as one of ... the world’s top women business owners. Winners have demonstrated that they have fast-growth ...
(Date:4/26/2017)... ... April 26, 2017 , ... Want to learn more ... CRISPRCas.pioneer.com ) that demonstrates how this advanced plant breeding technology is a more ... with fewer resources. It highlights the business’ principles, research and collaboration efforts in ...
(Date:4/25/2017)... ... April 25, 2017 , ... Splashtop ... Mirroring360 Pro . This new addition to the Mirroring360 product family combines device ... business. , Mirroring360 Pro enables educators, business professionals and individuals to stream or ...
(Date:4/25/2017)... ... 25, 2017 , ... A recent report from the Wisconsin ... the 2015-16 school year across Wisconsin’s public schools, charter schools, and private schools ... in student test score performance, the report’s limited analyses fail to provide answers ...
(Date:4/25/2017)... ... April 25, 2017 , ... ... in unveiling cutting-edge birth defects research related to Zika virus during pregnancy, as ... premier society for this important science. , The Teratology Society ...
Breaking Medicine News(10 mins):
(Date:4/19/2017)... 2017 Global Surgical Drainage Device Market: Overview ... to remove excess liquid and air. The fluid to ... or lymph. Surgical drains are used in a wide ... surgery, cardiovascular surgery, neurosurgery, plastic surgery etc. Common use ... accumulation of fluid e.g. blood or pus. Surgical drains ...
(Date:4/19/2017)... , April 19, 2017 ... stimulate an immune response in pets such as ... products are of various types such as Attenuated ... Toxoid Vaccines, DNA Vaccines and Recombinant Vaccines. Attenuated ... as virus or bacteria, which have been weakend ...
(Date:4/18/2017)... , April 18, 2017 Cogentix Medical, ... on providing the Urology, Uro/Gyn and Gynecology markets with ... the first quarter ended March 31, 2017 after the ... The Company will host a conference call and ... on Tuesday, May 2, 2017 at 4:30 p.m. Eastern ...
Breaking Medicine Technology: