Peroperative Evaluation of Extracranial-intracranial Bypass with Ultrasonographic Methods

Authors: J. Fiedler 1,2;  V. Přibáň 1,2;  M. Bombic 1
Authors‘ workplace: Neurochirurgické oddělení, Nemocnice České Budějovice, a. s. 1;  Neurochirurgická klinika LF MU a FN Brno 2
Published in: Cesk Slov Neurol N 2011; 74/107(1): 62-66
Category: Short Communication


The goal of this study was to evaluate low-flow extracranial-intracranial bypass patency using microvascular Doppler ultrasonography and to measure bypass blood flow values using transit time flow measurement, approaches that may lead to actual changes in operative strategy.

We performed 10 low-flow extracranial-intracranial bypass surgical operations between August 2008 and March 2010. Diagnosis of exhausted cerebrovascular reserve capacity was established by transcranial Doppler ultrasonography and challenge perfusion CT. We employed standard operational technique for low-flow bypass.

There was no 30-day neurological morbidity and mortality and only one asymptomatic bypass occlusion event. Using transit time flow measurement led to a change of operative strategy in three cases.

Peroperative monitoring by microvascular Doppler ultrasonography and transit time flow measurement is a simple and reproducible technique. It can reveal acute adverse changes in bypass blood flow that might result from technical error and allow the surgeon to take corrective measures immediately.

Key words:
cerebral revascularization – brain ischemia – Doppler ultrasonography – cerebrovascular circulation


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