Assessing Success after Cerebral Revascularization for Ischemia

Wanebo, John E.; Amin‐Hanjani, Sepideh; Boyd, Cynthia M.; Peery, Terry

doi:10.1055/s-2005-872597

Cited by 18 publications

(9 citation statements)

References 85 publications

(91 reference statements)

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“…Cerebral perfusion is an important target for assessing the effect of STA-MCA bypass in Moyamoya disease [18,19]. Owing to advances in modern imaging, which have improved our understanding of cerebral hemodynamics, there have been parallel advances in the study of cerebral perfusion in perioperative STA-MCA bypass for Moyamoya patients.…”

Section: Discussionmentioning

confidence: 99%

Perfusion-Weighted Magnetic Resonance Imaging Used in Assessing Hemodynamics following Superficial Temporal Artery-Middle Cerebral Artery Bypass in Patients with Moyamoya Disease

Zhou

Xiong

et al. 2013

Cerebrovasc Dis

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Background: The best strategy to assess the changes in brain hemodynamics following superficial temporal artery (STA)-middle cerebral artery (MCA) bypass in patients with Moyamoya disease remains unknown. The purpose of the present study was to assess cerebral hemodynamics using perfusion-weighted magnetic resonance imaging (PWI) before and after STA-MCA bypass surgery in patients with Moyamoya disease. Methods: STA-MCA bypass surgeries were performed on 23 symptomatic cerebral hemispheres in 21 patients (11 females/10 males, age 11-62 years) with Moyamoya disease due to cerebral ischemic attacks or intracranial hemorrhages. Brain PWI images were obtained in the frontal lobes, the temporal lobes, the occipital lobes, and the basal ganglia before and after STA-MCA bypass surgery. The relative parameters cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) derived from PWI were calculated. All patients underwent CT angiography or MR angiography after surgery in order to confirm the patency of bypass. Results: According to preoperative PWI, there was significant hypoperfusion in the symptomatic temporal and frontal lobes. According to postoperative PWI, the regional CBF had increased in both the temporal and frontal lobes on the operative side (p < 0.05, versus preoperative data). In the postoperative CBV maps, there was a significant decrease in the occipital lobe on the operative side (p < 0.05, versus preoperative data). The postoperative MTT in the temporal lobe, frontal lobe and basal ganglia area on the operative side was short, relative to the preoperative MTT (p < 0.05). The CT angiography or MR angiography imaging demonstrated patency of the bypass in all patients after surgery. During the follow-up period, all patients showed significant improvement in neurological function postoperatively. Conclusions: This study demonstrates that STA-MCA bypass is a safe and effective surgical treatment for Moyamoya disease. PWI enables an effective and objective assessment of hemodynamics before and after STA-MCA bypass surgery in patients with Moyamoya disease.

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Section: Discussionmentioning

confidence: 99%

Perfusion-Weighted Magnetic Resonance Imaging Used in Assessing Hemodynamics following Superficial Temporal Artery-Middle Cerebral Artery Bypass in Patients with Moyamoya Disease

Zhou

Xiong

et al. 2013

Cerebrovasc Dis

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“…13 The bypass patency can be visualized during surgery by videoangiography after injection of indocyanine green. 14,15 In a report by Johannes et al, two stenotic anastomoses shown on video were successfully revised. In this study, we checked the velocity of the donor and recipient vessels to confirm the patency of the anastomosis.…”

Section: Prediction Of Anastomotic Successmentioning

confidence: 95%

Prediction of flow augmentation and complications of extracranial–intracranial bypass in symptomatic cerebrovascular diseases

Chiu

Tsai

Chiu

2012

Journal of Clinical Neuroscience

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“…50 Vali-dated outcomes metrics evaluate functional neurological status and neurocognitive status. 73 …”

Section: Measuring Cerebral Hemodynamic Insufficiency: the Oxygen Extmentioning

confidence: 99%

“…73 The study looked at outcomes of CBF and the progression of neurophysiological function. The analysis revealed a significantly lower incidence of stroke recurrence for patients with Stage II ischemia undergoing bypass surgery than those treated with strict medical therapy.…”

Section: Recent Ongoing and Future Studiesmentioning

confidence: 99%

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The evolution of cerebral revascularization surgery

Hayden¹,

Lee²,

Guzman³

2009

FOC

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Among the relatively few surgeons to be awarded the Nobel Prize was Alexis Carrel, a French surgeon and pioneer in revascularization surgery at the turn of the 20th century. The authors trace the humble beginnings of cerebral revascularization surgery through to the major developments that helped shape the modern practice of cerebral bypass surgery. They discuss the cornerstone studies in the development of this technique, including the Extracranial/Intracranial Bypass Study initiated in 1977. Recent innovations, including modern techniques to monitor cerebral blood flow, microanastomosis techniques, and ongoing trials that play an important role in the evolution of this field are also evaluated.

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Assessing Success after Cerebral Revascularization for Ischemia

Cited by 18 publications

References 85 publications

Perfusion-Weighted Magnetic Resonance Imaging Used in Assessing Hemodynamics following Superficial Temporal Artery-Middle Cerebral Artery Bypass in Patients with Moyamoya Disease

Perfusion-Weighted Magnetic Resonance Imaging Used in Assessing Hemodynamics following Superficial Temporal Artery-Middle Cerebral Artery Bypass in Patients with Moyamoya Disease

Prediction of flow augmentation and complications of extracranial–intracranial bypass in symptomatic cerebrovascular diseases

The evolution of cerebral revascularization surgery

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