Superficial-Temporal-Artery-To-Middle-Cerebral-Artery Bypass in Cerebrovascular Occlusive Disease and Hemodynamic-Related Ischemia: Illustrative Case and Literature Review

Stroke is the third most common cause of death worldwide. About 10% to 15% of strokes related to the territory of the carotid artery are associated with its complete occlusion. There is an important subgroup of patients with cerebrovascular occlusive diseases who might benefit from an external-carotid-to-internal-carotid bypass. In the present study, we report a case of a 53-year-old male patient with stenosis of the M2 branch of themiddle cerebral artery (MCA), with a history of 20 episodes of transient ischemic accidents (TIA)s, in whom an anastomosis of the M4 branch of the superficial temporal artery-MCA was performed. The patient was discharged in three days, and in the two years of follow-up, they were no more TIAs.We also conducted a review of the literature on cerebrovascular occlusive disease and extracranial-intracranial bypass surgery. New methods to evaluate cerebral hemodynamics made it possible to classify a new subgroup of patients with symptomatic cerebrovascular disease and documented cerebrovascular compromise in whom the drug therapy fails, who can benefit from the extracranial-intracranial bypass. Our case report illustrates the advantages of revascularization in these selected patients.

Accidente vascular isquémico: Anestesia para trombectomía mecánica / Acute ischemic stroke: Anesthesia for mechanical thrombectomy

The management of patients presenting with an ischemic vascular accident has evolved in recent years. Several studies opened the possibility for endovascular treatment of these patients, improving their functional results. The evidence-based anesthetic management has changed thanks to new relevant literature. In this article we want to briefly describe the changes in the state of the art according to the new clinical evidence.

El manejo de los pacientes que presentan un accidente vascular isquémico ha evolucionado en los últimos años. Varios estudios abrieron la posibilidad para el tratamiento endovascular de estos pacientes, mejorando sus resultados funcionales. El manejo anestésico basado en evidencia a cambiado gracias a nueva literatura relevante. En este artículo queremos describir brevemente los cambios en el estado del arte según la nueva evidencia clínica.