Extracranial-intracranial vascular bypass graft for chronic ischemic cerebrovascular disease: A follow-up study / 中国脑血管病杂志

ABSTRACT

Objective: To investigate the effect of extracranial-intracranial vascular bypass graft on stroke prevention in patients with chronic ischemic cerebrovascular disease. Methods: The clinical data of 217 patients with chronic ischemic cerebrovascular disease whom underwent extracranial-intracranial bypass graft in Xuan Wu Hospital, the Capital Medical University from October 2000 to October 2009 were analyzed retrospectively. The angiographic data after the procedure, clinical symptoms, and xenon CT detecting the improvement of cerebral blood flow were followed-up. Results: Circled digit oneThe mean age of 217 patients was 42±13 years (86 females [39.6%], 131 males [60.4%]). All patients had ischemic symptoms six months before the procedure, including transient ischemic attack (117,53.9%), reversible ischemic neurological deficit (37,17.1%), and complete stroke (63,29.0%). All patients received hemodynamic evaluation before the procedure. It showed regional cerebral blood flow reduction in the affected vascular territory. Circled digit twoPreoperative angiography showed that there were 62 patients (28.6%) with moyamoya disease, 72(33.2%) with unilateral carotid artery occlusion, 57(26.3%) with unilateral middle cerebral artery occlusion, and 26 (12.0%) with carotid or middle cerebral artery severe stenosis which was difficult to be treated by intervention. Circled digit threeOf the 388 anastomoses, 380 was patent. The patency rate was 98.0%. After the procedure, 9 patients(4.1%) patients had intracranial hematoma, 1 (0.5%) died of intracranial hematoma caused cerebral hernia. Circled digit fourOf the 217 patients, 10(4.6%) were lost to follow-up. The mean follow-up period was 38±18 months in 172 patients. One year after the procedure, the clinical symptoms in 81 patients disappeared completely after the procedure. Circled digit fiveA total of 50 patients performed xenon CT for quantitative measurement of brain blood flow one month after the procedure. It showed that the regional cerebral blood flow was improved more significantly than that before the procedure (t = 3.312, P < 0.05). Conclusion: By the medium- and long-term clinical follow-up study for patients with chronic hemodynamic ischemic cerebrovascular disease after extracranial-intracranial bypass graft, it showed that the extracranial-intracranial bypass graft has better efficacy for patients with chronic ischemic cerebrovascular disease.