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 doi
|Contact: George Stamatis|
University Hospitals Case Medical Center