Extracranial-intracranial saphenous vein bypass for carotid or vertebral artery dissections: A report of six cases

M. K. Morgan*, L. H S Sekhon

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

76 Citations (Scopus)

Abstract

The management of carotid or vertebral artery dissections has generally been either conservative (with anticoagulation) or surgical (by proximal ligation or trapping procedures). However, identification and management of those patients with a high risk of stroke recurrence have been difficult. Six patients with carotid or vertebral artery dissections underwent a total of seven surgical procedures involving intracranial interpositional saphenous vein bypass grafts anastomosed distally beyond the point of dissection with trapping of the intermediate diseased section of the artery. It is suggested that this procedure be used in patients who have bilateral carotid or vertebral artery disease, persistent angiographic abnormalities (particularly aneurysms), or recurring ischemic events while undergoing anticoagulation therapy, or in whom anticoagulation is undesirable. This procedure has benefits over current surgical options because of the maintenance of high flow, the avoidance of abnormal watershed areas of flow, and the elimination of the risk of emboli. The procedure is compared to previous techniques of extracranial-intracranial bypass.

Original languageEnglish
Pages (from-to)237-246
Number of pages10
JournalJournal of Neurosurgery
Volume80
Issue number2
Publication statusPublished - 1994
Externally publishedYes

Keywords

  • arterial dissection
  • bypass procedure
  • carotid artery
  • saphenous vein graft
  • vertebral artery

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