The international EC/IC bypass study.

Amaducci, Laura; Flamm, Eugene S.; Haynes, R. Brian; Mohr, J. P.; Peerless, Sydney J.; Robertson, James T.; Tulleken, C. A. F.; Yonekawa, Y

doi:10.1161/01.str.13.2.247

Cited by 11 publications

(2 citation statements)

References 5 publications

(2 reference statements)

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“…The need for cerebral revascularization emerged by the 1960s, by which time pioneering work in blood vessel suturing, followed by revolutionary developments in the surgical technique, led to the first successful common carotid arteryinternal carotid artery (ICA) bypass in 1963 1 and the first superficial temporal artery (STA)-middle cerebral artery (MCA) bypass in 1967. This prompted the extracranial (EC)-intracranial (IC) Bypass Study, a randomized trial of medical therapy versus STA-MCA bypass in patients with carotid athero-occlusive disease, the results of which 9 were published in 1985, and refuted the usefulness of EC-IC bypass surgery. During that era, it was a common belief that patients with carotid occlusion and other cerebral ischemic conditions would improve with cerebral revascularization, and therefore, efforts were centered on the development of a variety of bypass techniques for both the anterior and the posterior circulation.…”

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confidence: 99%

Cerebral Revascularization

Hage

Amin‐Hanjani

Charbel

2013

Neurosurgery Quarterly

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Over the last half century, there has been significant progress in both the technique and the thought process involved in surgical cerebral revascularization. In this article, we review the state-of-the-art practice in cerebral revascularization, which includes the use of novel technologies and decision making in surgical techniques, in preoperative planning, and in postoperative monitoring. We also discuss the importance of flow measurement, a technique that has evolved the practice of cerebral revascularization by allowing for improved patient selection, appropriate patientspecific choice of bypass grafts, verification of intraoperative bypass success, and noninvasive and reliable postoperative follow-up. Technical advances in performing anastomosis aimed at reducing occlusion times during anastomosis are also discussed. Cerebral revascularization has truly become a state-of-the-art discipline involving cutting edge technology and demonstrating promising results. Nonetheless, much work remains to be carried out to further validate these methodologies and their impact on patient outcomes.

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confidence: 99%

Cerebral Revascularization

Hage

Amin‐Hanjani

Charbel

2013

Neurosurgery Quarterly

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“…In 1977 the EC-IC Bypass Study was initiated to address this issue. 2 The Clinical Refinement Phase (1985)(1986)(1987)(1988)(1989)(1990)(1991)(1992)(1993)(1994)(1995) began with the disappointing results of the EC-IC Bypass Study, which suggested that bypass was of no clinical benefit. 23,24 Although the surgery fell out of wide favor, some practitioners felt that the study misrepresented the benefit of bypass in properly selected patients.…”

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confidence: 99%

Flow-assisted surgical cerebral revascularization

Ashley

Amin‐Hanjani

Alaraj

et al. 2008

FOC

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✓Extracranial–intracranial bypass surgery has advanced from a mere technical feat to a procedure requiring careful patient selection and a justifiable decision-making paradigm. Currently available technologies for flow measurement in the perioperative and intraoperative setting allow a more structured and analytical approach to decision making. The purpose of this report is to review the use of flow measurement in cerebral revascularization, presenting algorithms for flow-assisted surgical planning, technique, and surveillance.

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