Postsurgical observations of mean hemispheric cerebral blood flow with patients receiving high-flow EC-IC bypass using a radial artery graft (preliminary report, one-year observation of 10 hemispheres).

BACKGROUND

When we encounter an inaccessible internal carotid artery lesion, we sacrifice the inaccessible internal carotid artery and, at the same time, establish a high-flow extracranial-to-intracranial arterial bypass (EC-IC bypass). Questions and concerns remain, however, about the dynamics of the patient's cerebral blood flow postoperatively.

METHOD

Ten hemispheres from 9 patients had received radial artery grafting as an EC-IC bypass with the simultaneous obstruction of the internal carotid artery. Their mean hemispheric cerebral blood flow (mCBF) was measured longitudinally during 1 year after surgery by single photon emission computed tomography (SPECT) and a 133Xenon-inhalation method.

RESULTS

The serial mCBF values of the five hemispheres with giant aneurysm or paracavernous meningioma were attenuated during the postoperative 3-month period and then returned to the normal range. In only one case did the postoperative reduction of mCBF fail to return to normal; in addition there was a memory disturbance that had developed and progressed. Five hemispheres with the ICA stenosis did not present reduction in mCBF. In three out of five hemispheres, transient elevation of mCBF at 1 month after surgery was observed.