Surgical Treatment of Cerebrovascular Disease with High Flow Bypass

Abstract

Twelve high flow bypass (HFB) surgeries with 6 saphenous vein grafts and 6 radial artery grafts were performed in 12 patients with cerebrovascular disease: 5 with giant internal carotid artery (ICA) aneurysms, 2 with ICA dorsal aneurysms, 1 with cervical ICA dissecting giant aneurysm, and 4 with occlusive vascular lesions. In 2 patients with ICA dorsal aneurysm, constructed HFB was removed after the successful clipping. In 10 other patients, patency of the graft was good in 90% with a mean follow-up period of 3.2 years and did not show any difference between the 2 grafts. The perioperative complications included 1 with intracerebral hemorrhage, 1 with hearing disturbance, and 1 with lethal lung thrombosis that unexpectedly occurred 2 weeks after surgery.
Reconstruction of ICA with HFB is an effective and reliable option for the surgical treatment of some cerebrovascular disease, particularly for those that require parent artery occlusion during surgery. In contrast, indication of HFB for occlusive vascular lesions remains controversial. Adequate selection of patients, sophisticated surgical techniques, and careful perioperative management are essential for success in HFB surgery.