Revascularization of cerebral ischemia after previous bilateral extracranial-intracranial bypass procedures V.S. Sottiurai, MD, PhD, L. Herbert, MD,

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Presentation transcript:

Revascularization of cerebral ischemia after previous bilateral extracranial-intracranial bypass procedures V.S. Sottiurai, MD, PhD, L. Herbert, MD, D. Hatter, MD Journal of Vascular Surgery Volume 26, Issue 1, Pages 160-163 (July 1997) DOI: 10.1016/S0741-5214(97)70163-0 Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Preoperative cerebral angiograms. A, Left EC-IC anastomosis at middle cerebral artery (arrow). B, Right EC-IC anastomosis at middle cerebral artery (arrow). C, Left external carotid stenosis (arrow) at cul de sac of occluded left internal carotid artery (arrow). D, Stenosis of right external carotid artery (arrow). E, Critical stenosis of left solitary vertebral artery (arrow). F, Postoperative magnetic resonance angiogram depicts transposition of vertebral artery to the side of common carotid artery (lower arrow). Upper arrow indicates branching of external carotid artery. Journal of Vascular Surgery 1997 26, 160-163DOI: (10.1016/S0741-5214(97)70163-0) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Preoperative cerebral angiograms. A, Left EC-IC anastomosis at middle cerebral artery (arrow). B, Right EC-IC anastomosis at middle cerebral artery (arrow). C, Left external carotid stenosis (arrow) at cul de sac of occluded left internal carotid artery (arrow). D, Stenosis of right external carotid artery (arrow). E, Critical stenosis of left solitary vertebral artery (arrow). F, Postoperative magnetic resonance angiogram depicts transposition of vertebral artery to the side of common carotid artery (lower arrow). Upper arrow indicates branching of external carotid artery. Journal of Vascular Surgery 1997 26, 160-163DOI: (10.1016/S0741-5214(97)70163-0) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Preoperative cerebral angiograms. A, Left EC-IC anastomosis at middle cerebral artery (arrow). B, Right EC-IC anastomosis at middle cerebral artery (arrow). C, Left external carotid stenosis (arrow) at cul de sac of occluded left internal carotid artery (arrow). D, Stenosis of right external carotid artery (arrow). E, Critical stenosis of left solitary vertebral artery (arrow). F, Postoperative magnetic resonance angiogram depicts transposition of vertebral artery to the side of common carotid artery (lower arrow). Upper arrow indicates branching of external carotid artery. Journal of Vascular Surgery 1997 26, 160-163DOI: (10.1016/S0741-5214(97)70163-0) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Preoperative cerebral angiograms. A, Left EC-IC anastomosis at middle cerebral artery (arrow). B, Right EC-IC anastomosis at middle cerebral artery (arrow). C, Left external carotid stenosis (arrow) at cul de sac of occluded left internal carotid artery (arrow). D, Stenosis of right external carotid artery (arrow). E, Critical stenosis of left solitary vertebral artery (arrow). F, Postoperative magnetic resonance angiogram depicts transposition of vertebral artery to the side of common carotid artery (lower arrow). Upper arrow indicates branching of external carotid artery. Journal of Vascular Surgery 1997 26, 160-163DOI: (10.1016/S0741-5214(97)70163-0) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Preoperative cerebral angiograms. A, Left EC-IC anastomosis at middle cerebral artery (arrow). B, Right EC-IC anastomosis at middle cerebral artery (arrow). C, Left external carotid stenosis (arrow) at cul de sac of occluded left internal carotid artery (arrow). D, Stenosis of right external carotid artery (arrow). E, Critical stenosis of left solitary vertebral artery (arrow). F, Postoperative magnetic resonance angiogram depicts transposition of vertebral artery to the side of common carotid artery (lower arrow). Upper arrow indicates branching of external carotid artery. Journal of Vascular Surgery 1997 26, 160-163DOI: (10.1016/S0741-5214(97)70163-0) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Preoperative cerebral angiograms. A, Left EC-IC anastomosis at middle cerebral artery (arrow). B, Right EC-IC anastomosis at middle cerebral artery (arrow). C, Left external carotid stenosis (arrow) at cul de sac of occluded left internal carotid artery (arrow). D, Stenosis of right external carotid artery (arrow). E, Critical stenosis of left solitary vertebral artery (arrow). F, Postoperative magnetic resonance angiogram depicts transposition of vertebral artery to the side of common carotid artery (lower arrow). Upper arrow indicates branching of external carotid artery. Journal of Vascular Surgery 1997 26, 160-163DOI: (10.1016/S0741-5214(97)70163-0) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Intraoperative specimen demonstrates necrotic thrombi in internal carotid cul de sac. Journal of Vascular Surgery 1997 26, 160-163DOI: (10.1016/S0741-5214(97)70163-0) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 Intraoperative photograph of long arteriotomy of common carotid artery (small arrows). Open arrows point to vein patch angioplasty of the external carotid artery. Solid arrow points to end-to-side vertebral carotid transposition. Journal of Vascular Surgery 1997 26, 160-163DOI: (10.1016/S0741-5214(97)70163-0) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions