Department of Neurological Surgery, University of Washington, Seattle, Washington, USA.
World Neurosurg. 2013 Sep-Oct;80(3-4):322-7. doi: 10.1016/j.wneu.2012.01.035. Epub 2012 Jan 25.
Extracranial-to-intracranial (EC-IC) bypass is a valuable tool in treating intracranial diseases requiring flow replacement or parent vessel sacrifice. Radial artery grafts (RAGs) and saphenous vein grafts (SVGs) have been used as conduits to provide adequate high flow revascularizations. It is a therapeutic challenge when these grafts are unavailable.
All EC-IC high flow cerebral revascularizations performed using conduits other than RAGs or SVGs were identified from a prospective cerebrovascular registry. These patients were retrospectively reviewed for surgical technique, graft patency, graft flow, and clinical outcomes.
Three patients (all women) underwent EC-IC bypass surgery using tibial artery grafts (two anterior tibial artery and one posterior tibial artery) because of the nonavailability of RAG or SVG. The two anterior tibial artery graft bypasses were patent with good flow at 8 and 3 months. The posterior tibial artery graft occluded intraoperatively. None of the patients developed vascular complications in the lower extremity due to tibial artery harvest.
Tibial arteries are safe, contingent alternatives to conventional conduits for performing high flow cerebral revascularizations and conduit reconstructions.
颅外-颅内（EC-IC）旁路是治疗需要血流替代或母血管牺牲的颅内疾病的一种有价值的工具。桡动脉移植物（RAG）和隐静脉移植物（SVG）已被用作提供足够高流量再血管化的导管。当这些移植物不可用时，这是一个治疗挑战。
从前瞻性脑血管登记处确定了所有使用 RAG 或 SVG 以外的导管进行的 EC-IC 高流量脑血运重建。对这些患者进行了回顾性手术技术、移植物通畅性、移植物流量和临床结果的回顾。
由于 RAG 或 SVG 不可用，三名女性患者（均为女性）接受了胫动脉移植物（两条胫前动脉和一条胫后动脉）的 EC-IC 旁路手术。两条胫前动脉旁路术通畅，8 个月和 3 个月时流量良好。胫后动脉移植物术中闭塞。由于胫骨动脉采集，下肢均未发生血管并发症。
胫动脉是进行高流量脑血运重建和导管重建的安全、候补替代传统导管的选择。
