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

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

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