Role of and Indications for Bypass Surgery After Carotid Occlusion Surgery Study (COSS)?

Esposito, Giuseppe; Amin‐Hanjani, Sepideh; Regli, Luca

doi:10.1161/strokeaha.115.008220

Cited by 103 publications

(90 citation statements)

References 55 publications

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“…Cerebral bypass surgery is classified according to the role of the bypass in flow-preservation and flow-augmentation procedures [1]. The role of a flow-preservation bypass is to replace the blood flow provided by a major intracranial vessel, the occlusion of which is necessary for treating an underlying disease (such as complex aneurysms).…”

mentioning

confidence: 99%

“…The role of a flow-preservation bypass is to replace the blood flow provided by a major intracranial vessel, the occlusion of which is necessary for treating an underlying disease (such as complex aneurysms). The role of a flowaugmentation bypass is to restore flow to hypoperfused brain territories (in patients with steno-occlusive diseases) [1][2][3].…”

mentioning

confidence: 99%

“…Flow-preservation bypass is instead nowadays very rarely indicated for managing tumors involving major cerebral arteries: in these cases the trend has evolved in favor of partial resection and radiotherapy [1]. For what concerns flow-augmentation bypass, it is currently recommended for Moyamoya patients with ischemic or hemorrhagic symptoms and compromised hemodynamics.…”

mentioning

confidence: 99%

“…For what concerns flow-augmentation bypass, it is currently recommended for Moyamoya patients with ischemic or hemorrhagic symptoms and compromised hemodynamics. Bypass is currently not recommended for patients with recently symptomatic carotid artery occlusion and failure of cerebral hemodynamics, but may be considered for patients with hemodynamic failure and recurrent symptoms despite optimal medical treatment [1].…”

mentioning

confidence: 99%

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Intraoperative tools for cerebral bypass surgery

Esposito

Regli

2018

Acta Neurochir

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confidence: 99%

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confidence: 99%

mentioning

confidence: 99%

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confidence: 99%

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Intraoperative tools for cerebral bypass surgery

Esposito

Regli

2018

Acta Neurochir

Self Cite

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“…(5,6) Hemodynamic factors were emphasized in those studies, such as the threshold of cerebral vasodilatory reserve, cerebrovascular reactivity, cerebral blood ow, and oxygen extraction fraction. (4,6,12,20) With strict hemodynamic criteria, direct revascularization could help preventing SIE. (21) In contrast, SIE occurred in 29.4% of patients receiving direct revascularization in our study.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Surgical Revascularizations in Young and Middle-aged Patients with Symptomatic Middle Cerebral Arterial Occlusion

Wang

Liu²,

Cao³

et al. 2020

Preprint

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Background: Treatments on middle cerebral arterial occlusions (MCAO) remain controversial. This study aims at investigating efficacies of surgical revascularizations in young and middle-aged patients (aged 18-65 y) with symptomatic MCAO, and making comparisons between surgical procedures.Methods: From a seven-year prospective consecutive registry, 115 cases were enrolled in this study. Patient individually received medical therapy alone (medical group, n=64) and medical therapy plus direct or indirect revascularization (surgical group, n=51). The secondary ischemic events (SIE) was defined as the primary outcome. SIE incidences and SIE-free survival rates were compared between groups. Risk factors were analyzed using the Cox regression analysis.Results: During a follow-up of 42.7 months on average, SIE occurred in 11cases of medical group and 10 cases of surgical group. SIE incidences were indifferent between groups (surgical:medical = 19.6%:17%, P=0.810, 95%CI 0.455-3.034). SIE incidences were 29.4% and 0% in direct revascularization subgroup and indirect revascularization subgroup, respectively. Indirect revascularization induced a higher SIE-free survival rate than direct revascularization (Log-rank P=0.015) and medical therapy (Log-rank P=0.044). An age>43y, with concomitant intracerebral arterial stenosis, and hyperlipidaemia history were correlated to the occurrence of SIE, while presences of compensatory arteries and taking antihypertensive drugs reduced risks of SIE.Conclusions: Indirect revascularization plus medical therapy was suggested to be more effective on SIE prevention than both medical treatments alone and direct revascularization plus medical therapy in young and middle aged patients with symptomatic MCAO. Direct revascularization was not recommended, for its similar efficacy to medical therapy alone.

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Hemodynamic Evaluation of Paradoxical Blood Oxygenation Level-Dependent Cerebrovascular Reactivity with Transcranial Doppler and MR Perfusion in Patients with Symptomatic Cerebrovascular Steno-occlusive Disease

Niftrik

Sebök

Muscas

et al. 2021

Cerebrovascular Reactivity

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Role of and Indications for Bypass Surgery After Carotid Occlusion Surgery Study (COSS)?

Abstract: The online-only Data Supplement is available with this article at http://stroke.ahajournals.org/lookup/suppl

Cited by 103 publications

References 55 publications

Intraoperative tools for cerebral bypass surgery

Intraoperative tools for cerebral bypass surgery

Efficacy of Surgical Revascularizations in Young and Middle-aged Patients with Symptomatic Middle Cerebral Arterial Occlusion

Hemodynamic Evaluation of Paradoxical Blood Oxygenation Level-Dependent Cerebrovascular Reactivity with Transcranial Doppler and MR Perfusion in Patients with Symptomatic Cerebrovascular Steno-occlusive Disease

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