Evolution in Cerebrovascular Bypass: Conceptual Framework, Technical Nuances, and Initial Clinical Experience with Fourth-Generation Bypass

Authors

Visish M. Srinivasan, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA.
Redi Rahmani, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA.
Mohamed A. Labib, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA.Follow
Michael J. Lang, Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Joshua S. Catapano, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA.Follow
Christopher S. Graffeo, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA.Follow
Michael T. Lawton, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA. Electronic address: Neuropub@barrowneuro.org.Follow

Document Type

Article

Abstract

Cerebrovascular bypass has undergone a remarkable evolution since its initial description. Recent developments have required the conceptualization of a fourth generation in bypass techniques, encompassing both unconventional suturing techniques (type 4A; eg, intraluminal suturing) and atypical vascular constructs (type 4B; eg, middle communicating artery bypass). This cohort study reports 44 bypass operations performed by a single cerebrovascular neurosurgeon from 1997 to 2021 among a total cohort of 750 bypasses. Most bypasses were for the treatment of complex aneurysms (36 of 44 cases, 89%). Although challenging, these operations empower novel approaches to a variety of otherwise untreatable lesions.

Medical Subject Headings

Cerebral Revascularization (methods); Cohort Studies; Humans; Intracranial Aneurysm (surgery); Neurosurgical Procedures (methods); Treatment Outcome

Publication Date

10-1-2022

Publication Title

Neurosurgery clinics of North America

E-ISSN

1558-1349

Volume

33

Issue

4

First Page

383

Last Page

402

PubMed ID

36229127

Digital Object Identifier (DOI)

10.1016/j.nec.2022.06.004

Recommended Citation

Srinivasan, Visish M.; Rahmani, Redi; Labib, Mohamed A.; Lang, Michael J.; Catapano, Joshua S.; Graffeo, Christopher S.; and Lawton, Michael T., "Evolution in Cerebrovascular Bypass: Conceptual Framework, Technical Nuances, and Initial Clinical Experience with Fourth-Generation Bypass" (2022). Neurosurgery. 1795.
https://scholar.barrowneuro.org/neurosurgery/1795