Staged intracranial and extracranial revascularization
J. M. Moran, O. H. Reichman and W. H. Baker
Twenty patients with a combination of intracranial and extracranial
cerebrovascular lesions were identified in a series comprised of 118
candidates for superficial temporal artery to middle cerebral artery
(STA-MCA) bypass. Ten patients had internal carotid (ICA) occlusion and
contralateral ICA stenosis, seven patients had combinations of ipsilateral
lesions, usually ICA occlusion and external carotid (ECA) stenosis, and
three patients had multiple lesions. Eighteen patients had a STA-MCA bypass
performed; 11 of these had contralateral reconstruction for ICA stenosis,
and seven had ECA stenosis corrected. Two additional patients became
asymptomatic after ECA endarterectomy only and their proposed STA-MCA
bypass has been postponed. There were two deaths, one early and one late.
Eleven patients are asymptomatic, five are improved, one is unchanged, and
one is neurologically worse.
