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At least 73 records · Page 4Linked to original sources
PubMed1997

Reversed-flow saphenous vein grafts for cerebral revascularization. Technical note.

The authors sought to create a saphenous vein interposition graft to be used in cerebral bypass procedures that would be more physiologically appropriate than standard vein grafts and would provide a better match between the graft and recipient vessels at the anastomotic sites. The saphenous vein graft was prepared by lysing the valves with a valvulotome. The blood flow could then be reversed in the vein, allowing it to be used in either direction as a bypass graft. An illustrative case including angiograms that confirm good patency and blood flow through the reversed-flow bypass graft is presented. It is concluded that the reversed-flow saphenous vein graft provides a more physiologically suitable conduit than standard vein grafts. Lysis of the valves allows the graft to be used in an orientation that takes advantage of the natural tapering of the vein to produce a better match with the recipient vessels at the anastomotic sites. Minimizing diameter changes at the proximal and distal anastomoses helps reduce turbulence, which has been implicated as a cause of early graft failure and thrombosis.

Cerebral Revascularization↗
PubMed1994

Interventional neurovascular techniques for cerebral revascularization in the treatment of stroke.

Recent advances in interventional neurovascular radiology have altered the management of cerebrovascular diseases by providing alternative treatments in three areas. (1) Cerebral percutaneous transluminal angioplasty is being used more often as an alternative to surgical endarterectomy or bypass grafting for patients with high-grade vascular stenosis of the innominate, subclavian, carotid, vertebral, and intracranial blood vessels. To date, the success rate has been greater than 90%, with less than 10% morbidity. (2) Transluminal angioplasty and local infusion of antispasmodic drugs are being used to treat patients with severe angiographic vasospasm unresponsive to conventional medical therapy. Intracranial arterial vasospasm due to subarachnoid hemorrhage has remained a leading cause of delayed morbidity and mortality. Neurologic improvement, defined as improvement in the Hunt and Hess neurologic grading scale, has been shown in 60-80% of the patients so treated. (3) Local intraarterial fibrinolysis has been beneficial for patients with acute thromboembolic occlusion in both intracranial arteries and the cerebral dural sinuses. Preliminary studies indicate that early revascularization is associated with improved neurologic outcome. This review delineates the current state of the art in interventional neurovascular techniques for treating patients with stroke in evolution and patients with signs and symptoms of impending stroke due to vascular stenosis or occlusion. These techniques for cerebral revascularization are under investigation as potential life-saving therapy when conventional medical or surgical treatment has failed. As more experience is gained, the results of controlled clinical trials become available, and technical improvements evolve, these procedures will decrease the morbidity and mortality associated with strokes.

Angioplasty, Balloon↗
PubMed1981

The controlled delivery of thiopental and delayed cerebral revascularization.

Sodium thiopental was administered to 10 dogs following embolization of the middle cerebral artery. Its effect on the "grace period" for revascularization was investigated by performing embolectomies 6 hours later. We observed a striking reduction in the size of infarction in the animals treated with thiopental at moderate and prolonged dosage levels. The control animals treated with pentobarbital received less protection against ischemia although blood levels were similar to those of the experimental groups during the period of vascular occlusion.

Animals↗
PubMed1980

Cerebral revascularization by transverse cervical-common carotid artery anastomosis.

A surgical procedure to bypass occlusive lesions of the proximal common carotid or vertebral artery is described. The case of a patient with recurrent cerebral ischemic episodes associated with proximal left common carotid stenosis is reported. A left transverse cervical-common carotid artery anastomosis was performed. It is suggested that this simple procedure may be useful in selected cases.

Arterial Occlusive Diseases↗
PubMed1993

Cerebral revascularization using omental transplantation for childhood moyamoya disease.

Between January, 1986, and October, 1990, 30 children with moyamoya disease, aged from 2 to 17 years, underwent omental transplantation to either the anterior or the posterior cerebral artery territory. The mean follow-up period was 3.8 years, ranging from 1.6 to 6.4 years. Seventeen patients had symptoms of monoparesis, paraparesis, and/or urinary incontinence and were treated using unilateral or bilateral omental transplantation to the anterior cerebral artery territory. Eleven patients had visual symptoms and were treated with unilateral or bilateral omental transplantation to the posterior cerebral artery territory. Two patients had symptoms associated with both the anterior and the posterior cerebral arteries, and were treated with dual omental transplantations. All 19 patients treated with omental transplantation to the anterior cerebral artery and 11 (84.6%) of the 13 treated with omental transplantation to the posterior cerebral artery showed improvement in their neurological state. Patients with more collateral vessels via the omentum had more rapid and complete improvement in their neurological state. Patients with severe preoperative neurological deficits associated with the posterior cerebral artery had persistence of their symptoms.

Adolescent↗