STA-MCA bypass for symptomatic carotid occlusion and haemodynamic impairment

Jeffree, Rosalind L. and Stoodley, Marcus A. (2009) STA-MCA bypass for symptomatic carotid occlusion and haemodynamic impairment. Journal of Clinical Neuroscience, 16 2: 226-235. doi:10.1016/j.jocn.2008.01.022


Author Jeffree, Rosalind L.
Stoodley, Marcus A.
Title STA-MCA bypass for symptomatic carotid occlusion and haemodynamic impairment
Journal name Journal of Clinical Neuroscience   Check publisher's open access policy
ISSN 0967-5868
1532-2653
Publication date 2009-01-01
Sub-type Article (original research)
DOI 10.1016/j.jocn.2008.01.022
Open Access Status Not Open Access
Volume 16
Issue 2
Start page 226
End page 235
Total pages 10
Place of publication London, United Kingdom
Publisher Churchill Livingstone
Language eng
Subject 2728 Clinical Neurology
2737 Physiology (medical)
2808 Neurology
Formatted abstract
Patients with carotid artery occlusion and haemodynamic insufficiency have a high risk of stroke. Cerebral revascularization surgery improves cerebral blood flow, but it remains unclear whether this reduces the risk of stroke. This study assesses the long-term outcome of patients undergoing superficial temporal artery to middle cerebral artery (STA-MCA) bypass for symptomatic carotid occlusion. The long-term clinical follow-up and haemodynamic reserve, measured by 99Technetium single photon emission computed tomography (Tc99 SPECT) scan with acetazolamide challenge, were reviewed for 19 consecutive patients before and after STA-MCA bypass. The stroke rate after bypass surgery was 8% per year. In patients waiting for surgery, the stroke rate was 18% per year. Cerebral perfusion assessed with SPECT scan improved in 88% of patients. These results are consistent with the high risks of haemodynamic infarction in untreated patients and a benefit from revascularization surgery. The percentage annual stroke risk compares favourably with an 18% rate reported for patients with internal carotid artery occlusion and impaired cerebrovascular reserve.
Keyword Carotid occlusion
Cerebral ischemia
Cerebral revascularization
Cerebrovascular insufficiency
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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