STA-MCA Bypass Under Local Anesthesia

Kaku, Yasuhiko; Yamada, Tetsuya; Kanou, Kiyomitsu; Oka, Naoki; Yamashita, Kentarou; Kokuzawa, Jouji

doi:10.1007/978-3-319-73739-3_11

Cited by 2 publications

(1 citation statement)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The risk of perioperative complications, including stroke and death, is greater in therapeutic compared with prophylactic bypass. 7-12 Moyamoya disease is considered the safest indication for arterial bypass. However, the literature appraising complication rates evaluated cohorts before the landmark Japan Adult Moyamoya trial, which sparked a resurgence of interest in arterial bypass.…”

mentioning

confidence: 99%

Modern Appraisal of Patency and Complications in Cerebral Bypass Surgery: A Single Institution Experience

Farooq

Heller

Noureldine

et al. 2022

Operative Neurosurgery

View full text Add to dashboard Cite

BACKGROUND: Cerebral bypass is a valuable surgical technique in well-selected patient populations. Updated clinical guidelines and improved surgical techniques warrant a contemporary reevaluation of the complications and patency to inform clinical practice and enhance postoperative patient care. OBJECTIVE: To assess the complication rates and postoperative graft patency for the 3 most common indications for bypass surgery: moyamoya disease, intracranial atherosclerosis, and intracranial aneurysms. METHODS: Perioperative notes of 175 consecutive bypass patients at a single institution were retrospectively identified to evaluate the clinical course and complications of surgery. RESULTS: The rate of total postoperative complications between moyamoya disease (9 of 98, 9.2%), intracranial atherosclerotic disease (7 of 57, 12.3%), and intracranial aneurysm (4 of 20, 20%) was not statistically different (P = .33). Immediate postoperative bypass patency was significantly higher in moyamoya disease (90 of 96, 93.8%) and intracranial atherosclerotic disease (48 of 51, 94.1%) than in intracranial aneurysm (13 of 18, 72.2%; P = .02). Intravenous heparin administration during bypass suturing was negatively associated with immediate postoperative patency (87% heparin patency vs 99% no heparin patency; P = .02). Double-barrel bypass trended toward an increased risk of wound healing complications (2 of 13, 15.4%) compared with the single-barrel bypass technique (4 of 156, 2.6%; P = .07). CONCLUSION: Cerebral bypass surgery remains an excellent surgical treatment for moyamoya disease, intracranial atherosclerosis, and intracranial aneurysms. This study suggests bypass is safer in moyamoya disease and intracranial atherosclerosis. Additional studies to clarify the risk of single-barrel vs double-barrel bypass and intraoperative heparin-stratified complications may be beneficial.

show abstract

mentioning

confidence: 99%