Bending the Curve: Preoperative Determination of Bypass Graft Length and Trajectory With Curved Planar Reformatted Computed Tomography Angiography: Technical Note

2011 ◽  
Vol 70 (suppl_2) ◽  
pp. onsE327-onsE331
Author(s):  
Jeffrey C. Markham ◽  
Christopher S. Eddleman ◽  
David Uhrbrock ◽  
Babu G. Welch
Keyword(s):  
Computed Tomography ◽  
Bypass Graft ◽  
External Carotid Artery ◽  
Technical Note ◽  
Cerebral Revascularization ◽  
External Carotid ◽  
Efficient Manner ◽  
Curved Planar Reformation ◽  
Graft Length

ABSTRACT BACKGROUND AND IMPORTANCE: Cerebral revascularization continues to be an important technique for the treatment of cerebrovascular and vaso-occlusive diseases, and determination of appropriate graft sources and recipients is paramount to the success of the procedure. A tension-free anastomosis requires that harvested grafts be of an appropriate length to avoid complications. Volume-rendered contrast-enhanced computed tomography data sets may be useful in determining the desired length and path of the bypass graft and in the evaluation of appropriate recipient vessels. Curved planar reformation techniques may allow these properties to be determined in a novel, inexpensive, and efficient manner. CLINICAL PRESENTATION: A 63-year-old patient with a left hemispheric perfusion deficit and without an external carotid artery was in need of high-flow cerebral revascularization. A radial artery graft spanning from the vertebral artery to the middle cerebral artery was proposed. Preoperative determination of graft length necessary and most efficient subcutaneous placement was desired. A standard computed tomography angiogram of the head and neck was obtained and imported into a computer workstation with curved planar reformatting capabilities. CONCLUSION: Curved planar reformation technique can be used for preoperative planning of cerebral bypass procedures and is a novel, inexpensive, and efficient means of determining the desired length and path of the bypass graft and in the evaluation of appropriate recipient vessels.

Computed tomography and magnetic resonance angiography in the evaluation of aberrant origin of the external carotid artery branches

2012 ◽  
Vol 34 (5) ◽  
pp. 393-399 ◽  
Author(s):  
Salvatore Cappabianca ◽  
Assunta Scuotto ◽  
Francesco Iaselli ◽  
Nicoletta Pignatelli di Spinazzola ◽  
Fabrizio Urraro ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Carotid Artery ◽  
External Carotid Artery ◽  
External Carotid

Subclavian-External Carotid Artery Bypass Graft

AORN Journal ◽  
1989 ◽  
Vol 50 (2) ◽  
pp. 361-368
Author(s):  
Jon Senkowsky ◽  
Florence L. Smith ◽  
Morris D. Kerstein
Keyword(s):  
Carotid Artery ◽  
Artery Bypass ◽  
Bypass Graft ◽  
External Carotid Artery ◽  
External Carotid ◽  
Artery Bypass Graft

Bilateral External Carotid Artery Aneurysms

Vascular ◽  
2004 ◽  
Vol 12 (6) ◽  
pp. 387-389 ◽  
Author(s):  
Vladimir Grigoryants ◽  
Matthew J. Eagleton ◽  
Gilbert R. Upchurch
Keyword(s):  
Computed Tomography ◽  
Cerebral Ischemia ◽  
Carotid Artery ◽  
Physical Examination ◽  
Cranial Nerve ◽  
External Carotid Artery ◽  
External Carotid ◽  
Local Pain ◽  
Neck Masses

A 60-year-old female was found on a physical examination to have bilateral palpable pulsatile neck masses. She denied local pain, cranial nerve compressive symptoms, or symptoms of cerebral ischemia. Duplex ultrasonography demonstrated bilateral 1.5 x 2.2 cm external carotid artery aneurysms. Isolated bilateral external carotid artery aneurysms were confirmed by computed tomography and angiography. The patient has been treated conservatively, and at 4-year follow-up, she remains asymptomatic, and the carotid artery aneurysms are unchanged in size.

scholarly journals Launay’s External Carotid Vein

Medicina ◽  
2021 ◽  
Vol 57 (9) ◽  
pp. 985
Author(s):  
Mihaela Daniela Manta ◽  
Adelina Maria Jianu ◽  
Mugurel Constantin Rusu ◽  
Şerban Arghir Popescu
Keyword(s):  
Computed Tomography ◽  
Carotid Artery ◽  
Jugular Vein ◽  
External Carotid Artery ◽  
External Jugular Vein ◽  
External Carotid ◽  
The Third ◽  
Facial Vein ◽  
The Common ◽  
Anterior Division

Background and Objectives: Launay’s external carotid vein (ECV) is poorly represented in the anatomical literature, although it is an occasional satellite of the external carotid artery (ECA). We aimed to establish the incidence and morphology of the ECV. Materials and Methods: One hundred computed tomography angiograms were investigated, and ECVs were documented anatomically, when found. Results: Launay’s vein was found in 3/200 sides (1.5%) in a male and two female cases. In two of these cases, the ECV was a replaced variant of the anterior division of the retromandibular vein (RMV), and the facial vein (FV) ended in the external jugular vein. In the third case with the ECV, the RMV was absent and the common FV that resulted from that ECV and the FV drained into the internal jugular vein. The ECV could also appear as an accessory RMV, not just as a replaced one. Additional variants were found, such as fenestration of the external jugular vein (EJV), the extracondylar vein draining the deep temporal veins and an arterial occipitoauricular trunk. Conclusions: Surgical dissections of the ECA in the retromandibular space should carefully observe an ECV to avoid unwanted haemorrhagic events. Approaches of the neck of the mandible should also carefully distinguish the consistent extracondylar veins.

scholarly journals Prospective evaluation of ultrafast cardiac computed tomography for determination of coronary bypass graft patency.

Circulation ◽  
1987 ◽  
Vol 75 (5) ◽  
pp. 1018-1024 ◽  
Author(s):  
T M Bateman ◽  
R J Gray ◽  
J S Whiting ◽  
D H Sethna ◽  
D S Berman ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cardiac Computed Tomography ◽  
Bypass Graft ◽  
Coronary Bypass ◽  
Graft Patency ◽  
Prospective Evaluation ◽  
Coronary Bypass Graft

Basilar Trunk Aneurysm Surgically Treated with Anterior Petrosectomy and External Carotid Artery-to-Posterior Cerebral Artery Bypass: Technical Note

Neurosurgery ◽  
2002 ◽  
Vol 51 (4) ◽  
pp. 1083-1088 ◽  
Author(s):  
Shunsuke Terasaka ◽  
Koji Itamoto ◽  
Kiyohiro Houkin
Keyword(s):  
Carotid Artery ◽  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Artery Bypass ◽  
Vascular Reconstruction ◽  
External Carotid Artery ◽  
Technical Note ◽  
High Flow ◽  
External Carotid ◽  
Anterior Petrosectomy

Abstract OBJECTIVE We discuss a detailed surgical technique, its indications, and potential pitfalls in its use. METHODS A surgical procedure combining Kawase's anterior petrosectomy and external carotid artery-to-posterior cerebral artery high-flow bypass was performed for the treatment of a patient with a fusiform basilar trunk aneurysm. RESULTS Follow-up angiography revealed the successful obliteration of the aneurysm and that the graft was functioning well. Late ischemic complications, however, occurred 5 weeks after surgery. CONCLUSION Kawase's approach is a versatile option for safe vascular reconstruction of the posterior cerebral artery and exposure of a basilar trunk aneurysm in the upper clival region. Although, theoretically, a high-flow bypass might decrease the risk of hemodynamic ischemia, it does not prevent thromboembolic complications.

Republished: Thrombectomy for late occlusion of high flow extracranial–intracranial saphenous vein bypass graft after 27 years of patency

2018 ◽  
Vol 10 (11) ◽  
pp. e27-e27
Author(s):  
Michael A Silva ◽  
Rodolfo E Alcedo Guardia ◽  
Mohammad Ali Aziz-Sultan ◽  
Nirav J Patel
Keyword(s):  
Saphenous Vein ◽  
Saphenous Vein Graft ◽  
Bypass Graft ◽  
External Carotid Artery ◽  
High Flow ◽  
Posterior Circulation ◽  
External Carotid ◽  
Vein Bypass ◽  
Basilar Occlusion

High flow extracranial–intracranial (EC-IC) bypass with a saphenous vein graft (SVG) has been used for more than 40 years in patients with giant aneurysms of the posterior circulation refractory to medical management, and has demonstrated high long term patency rates. We report the case of a patient treated with external carotid artery (ECA)–posterior cerebral artery SVG bypass in 1989 who presented 27 years later with paresthesias and confusion, and was found to have partial occlusion of her SVG bypass graft and a basilar occlusion. She was treated with mechanical thrombectomy of the basilar occlusion via the partially thrombosed graft, the first report of such a procedure through a high flow posterior circulation EC-IC SVG, resulting in improvement of the patient’s neurologic examination. At 27 years, this is the longest reported delay in thrombosis of a high flow SVG bypass graft, highlighting the long term patency of these grafts and the feasibility of thrombectomy through occluded bypass grafts.

Diagnostic and therapeutic alternatives in patients with symptomatic “carotid occlusion” referred for extracranial-intracranial bypass surgery

1981 ◽  
Vol 54 (6) ◽  
pp. 790-796 ◽  
Author(s):  
Roberto C. Heros ◽  
Laligam N. Sekhar
Keyword(s):  
Carotid Artery ◽  
Bypass Graft ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
External Carotid Artery ◽  
External Carotid ◽  
Content Type ◽  
Symptomatic Carotid ◽  
Number Of Patients ◽  
Therapeutic Alternatives

✓ An increasing number of patients with symptomatic carotid artery occlusion are being referred for extracranial to intracranial bypass grafts. After careful clinical and angiographic assessment, a number of these patients have been treated with a direct approach to the carotid arteries in the neck or with anticoagulation rather than with a bypass graft. These patients may be categorized diagnostically under the following headings: 1) complete occlusion of the internal carotid artery (ICA) with intracranial patency; 2) spontaneous dissection of the ICA; 3) atheromatous pseudo-occlusion; 4) carotid artery occlusion with stenosis of the contralateral ICA; 5) occlusion of the ICA and stenosis of the external carotid artery; and 6) thrombus in the intracranial segment of an occluded ICA. Each of these categories is discussed briefly, and illustrative cases are presented.

scholarly journals High flow EC–IC bypass for a giant left MCA aneurysm

2015 ◽  
Vol 38 (videosuppl1) ◽  
pp. Video9
Author(s):  
Eric J. Arias ◽  
Gregory J. Zipfel
Keyword(s):  
Artery Bypass ◽  
Bypass Graft ◽  
Cerebral Aneurysms ◽  
Artery Aneurysm ◽  
External Carotid Artery ◽  
High Flow ◽  
External Carotid ◽  
Left Middle Cerebral Artery ◽  
Mca Aneurysm ◽  
Cerebral Artery Aneurysm

Giant cerebral aneurysms may be treated through a variety of options, including aneurysm trapping with concurrent bypass. This video describes the case of a large, recurrent, left middle cerebral artery aneurysm that was treated using a high flow, radial artery bypass graft, from the external carotid artery to the left temporal M2 branch. A step-by-step operative description, with emphasis on proper microsurgical technique, is included.The video can be found here: http://youtu.be/9xTMC6InivQ.

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