Revision Superficial Temporal Artery-Middle Cerebral Artery Bypass Surgery for Recurrent Acute Ischemic Stroke Due to Delayed Occlusion of the Bypass Graft.
10.7461/jcen.2018.20.2.127
- Author:
Yun Hee CHOI
1
;
Hyun Seok PARK
;
Myong Jin KANG
;
Jae Kwan CHA
Author Information
1. Department of Neurosurgery, Busan-Ulsan Regional Cardio-Cerebrovascular Center, Dong-A University College of Medicine, Busan, Korea. nsparkhs@dau.ac.kr
- Publication Type:Case Report
- Keywords:
Stroke;
Cerebral revascularization;
Vascular graft occlusion;
Reoperation
- MeSH:
Carotid Artery, Internal;
Cerebral Arteries*;
Cerebral Infarction;
Cerebral Revascularization;
Emergencies;
Graft Occlusion, Vascular;
Humans;
Infarction, Middle Cerebral Artery;
Reoperation;
Reperfusion;
Stroke*;
Transplants*
- From:Journal of Cerebrovascular and Endovascular Neurosurgery
2018;20(2):127-132
- CountryRepublic of Korea
- Language:English
-
Abstract:
Intravenous thrombolysis (IVT) and endovascular treatment (EVT) are currently the main treatments for reperfusion in acute ischemic stroke. Although the EVT recanalization rate has increased, unsuccessful recanalization is still observed in 10-30% cases. Superficial temporal artery-middle cerebral artery (STA-MCA) bypass is considered a rescue therapy in such cases, but in most centers it is not usually performed for acute ischemic stroke. Graft occlusion is rare following STA-MCA bypass, but it might lead to recurrent ischemic stroke. We hereby report on a patient with right MCA infarction and in whom EVT failed due to complete proximal internal carotid artery occlusion. He underwent an emergency STA-MCA bypass, resulting in a full recovery of his motor weakness. However, six months later, the patient experienced recurrent acute ischemic stroke due to bypass graft occlusion. His EVT failed again but revision bypass surgery, using STA remnant branch, was successful with full motor weakness recovery. We recommend a revision bypass surgery as a feasible therapeutic option for recurrent cerebral infarction caused by delayed STA graft occlusion.
