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Cerebral Revascularization

  • Chapter
Advances and Technical Standards in Neurosurgery

Part of the book series: Advances and Technical Standards in Neurosurgery ((NEUROSURGERY,volume 28))

Abstract

During the last 10 years, there has been a revival of interest in cerebral revascularization procedures. Not only have significant progressions in surgical techniques been published, the use of more advanced diagnostic methods has led to a widening of the indications for cerebral bypass surgery. The purpose of this review is to outline the current techniques for extracranial-to-intracranial (EC/IC) and intracranial-to-intracranial (IC/ IC) bypass surgery, as well as to identify the current indications for revascularization procedures based on the available literature. The excimer laser-assisted non-occlusive anastomosis (ELANA) technique is described in more detail because we think that this technique almost completely eliminates the risk of cerebral ischemia due to the temporary vessel occlusion which is currently used in conventional anastomosis techniques.

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Abbreviations

ACA:

Anterior cerebral artery

AICA:

Anterior inferior cerebellar artery

BA:

Basilar artery

BTO:

Balloon test occlusion

CBF:

Cerebral blood flow

CCA:

Communid carotid artery

CT:

Computed tomography

CTA:

Computed tomographic angiography

EC/IC:

Extracranial-to-intracranial

ECA:

External carotid artery

ELANA:

Excimer laser-assisted non-occlusive anastomosis

IC/IC:

Intracranial-to-intracranial

te]ICA:

Internal carotid artery

IOA:

Intra-operative angiography

MCA:

Middle cerebral artery

MRA:

Magnetic resonance angiography

MRF:

Magnetic resonance flowmetry

MRI:

Magnetic resonance imaging

MRPCA:

Magnetic resonance phase contrast angiography

OA:

Occipital artery

OEF:

Oxygen extraction fraction

OphthA:

Ophthalmic artery

PCA:

Posterior cerebral artery

PComA:

Posterior communicating artery

PET:

Positron emission tomography

PICA:

Posterior inferior cerebellar artery

PTA:

Posterior temporal artery

RA:

Radial artery

rCBF:

Regional cerebral blood flow

SCA:

Superior cerebellar artery

SEP:

Somatosensory evoked potential recording

SPECT:

Single proton emission computed tomography

STA:

Superficial temporal artery

SubclA:

Subclavian artery

SVG:

Saphenous vein graft

TCD:

Transcranial Doppler velocity flowmetry

TIA:

Transient ischemic attack

USF:

Ultrasound flowmetry

VA:

Vertebral artery

Xe CBF:

Xenon inhalation cerebral blood flowmetry

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Authors and Affiliations

  1. Department of Neurosurgery, Brain Division, University Medical Center-Utrecht, The Netherlands

    H. J. N. Streefkerk, A. Van der Zwan & C. A. F. Tulleken

  2. Department of Medical Physics, Division of Medical Technology and Multimedia, University Medical Center-Utrecht, The Netherlands

    R. M. Verdaasdonk

  3. Department of Biomedical Engineering, Division of Medical Technology and Multimedia, The Netherlands

    H. J. Mansvelt Beck

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    J. D. Pickard

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    C. A. F. Tulleken

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Streefkerk, H.J.N., Van der Zwan, A., Verdaasdonk, R.M., Mansvelt Beck, H.J., Tulleken, C.A.F. (2003). Cerebral Revascularization. In: Pickard, J.D., et al. Advances and Technical Standards in Neurosurgery. Advances and Technical Standards in Neurosurgery, vol 28. Springer, Vienna. https://doi.org/10.1007/978-3-7091-0641-9_3

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