Extracranial-intracranial bypass for reconstruction of internal carotid artery in the management of head and neck cancer.

نویسندگان

  • Hideaki Chazono
  • Yoshitaka Okamoto
  • Zensei Matsuzaki
  • Jun Ogino
  • Shuichiro Endo
  • Tomokazu Matsuoka
  • Tooru Horikoshi
  • Hideaki Nukui
  • Hiromu Hadeishi
  • Nobuyuki Yasui
چکیده

Extracranial-intracranial bypass surgery was performed prior to carotid resection in eight patients with head and neck carcinoma that involved the carotid artery near the skull base. Four patients underwent the standard one-stage extracranial-intracranial bypass procedure. A two-stage procedure was performed in the remaining four patients. The procedure first involved an anastomosis between the M3 segment of the middle cerebral artery and the superficial temporal artery, followed by a bypass between the M2 segment of the middle cerebral artery and the internal carotid artery. One of the patients who underwent the standard one-stage extracranial-intracranial bypass procedure suffered an intraoperative infarction. Despite even longer occlusion times of the M2 segment, none of the patients who underwent the two-stage bypass suffered from any serious neurologic consequences. Three of seven patients who underwent the curative operations, survived more than 4 years, however, the remaining patients died within 1 year from recurrence. Our results show that carotid artery resection yields an opportunity for cure. In extracranial-intracranial bypass surgery, the temporary occlusion of the middle cerebral artery may also induce serious ischemia; however, the two-stage extracranial-intracranial bypass procedure appears to minimize the risk.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Symptomatic non-atherosclerotic bilateral extracranial vertebral artery occlusion treated with extracranial to intracranial bypass: case report.

Posterior fossa ischemia is not a very frequent situation. It is responsible for about 25% of all ischemic strokes, and the vast majority of the cases are related to atherosclerotic stenosis of the vertebral and/or basilar arteries. Acute ischemia can also occur in the setting of vertebral artery dissection, traumatic or spontaneous. Recently, blunt trauma has been increasingly recognized as a ...

متن کامل

Bypass to the intracranial giant or large internal carotid artery aneurysms: superficial temporal artery to middle cerebral artery bypass re-visited.

OBJECTIVE Hunterian ligation of the internal carotid artery is an acceptable treatment modality for inoperable intracranial carotid aneurysms. Despite the risk of thrombo-embolic complications, ligation together with superficial temporal artery-middle cerebral artery (STA-MCA) bypass surgery is vital in some patients. Our aim is to present our experience in five patients in whom STA-MCA bypass ...

متن کامل

Double-barrel extracranial–intracranial bypass surgery followed by endovascular carotid artery occlusion in a patient with an extracranial giant internal carotid artery aneurysm due to Ehlers–Danlos syndrome

OBJECTIVE In this case report we describe a successful interdisciplinary approach (including flow redirection and endovascular occlusion) applied to a patient with a continuously growing extracranial giant aneurysm of the right internal carotid artery (ICA) due to known Ehlers-Danlos syndrome. CASE PRESENTATION A 42-year-old man with a continuously growing extracranial giant aneurysm of the r...

متن کامل

Treatment of Supraclinoid Internal Carotid Artery Iatrogenic Pseudoaneurym with Extracranial-to- Intracranial Bypass and Trapping: Demonstration of Technique with Video Presentation.

Intracranial pseudoaneurysms (IP) represent about 1% of all patients presenting with an intracranial aneurysm. In true intracranial aneurysms, the intima, internal elastic lamina, and media are disrupted, but the adventitia is intact. In pseudoaneurysms, there is disruption of all three layers of the arterial wall, thus resulting in higher rates of re-hemorrhage and thrombus formation. Patients...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:
  • Annals of vascular surgery

دوره 17 3  شماره 

صفحات  -

تاریخ انتشار 2003