Abstract
Fourteen patients underwent intracranial to extracranial bypass anastomosis procedures for intracranial vertebrobasilar occlusive diseases.
There were 4 patients with occipital artery (OA) to posterior inferior cerebellar artery (PICA) anastomosis, 3 patients with superficial temporal artery (STA) to superior cerebellar artery (SCA), and 7 patients with interposed saphenous vein graft from external carotid artery (ECA) to SCA. Venous graft might be considered as a successful substitute for the SCA if the STA is not sufficiently long and large. We describe the technique interposing venous graft bypass from the external carotid to the superior cerebellar artery.
Postoperative angiograms demonstrated good patency of anastomosis in all patients. In this series, the mortality rate was 0%, transient morbidity including IVth nerve palsy occurred in 2 patients and CSF wound collection in 2 other patients.
The STA-SCA anastomosis and interposed vein graft from ECA to SCA were both well tolerated and technically easier than OA-PICA anastomosis procedure. Surgical revascularization should be offered in the ischemia of the rostral brain stem. STA-SCA anastomosis or interposed vein graft from ECA to SCA might play a favorable role in the management of intracranial vertebrobasilar occlusive diseases.
