caa a22 4500 477108210 CHVBK 20180405111601.0 cr unu---uuuuu 170330e19960801xx s 000 0 eng 10.1007/BF01411282 doi (NATIONALLICENCE)springer-10.1007/BF01411282 Long-term evaluation of EC-IC bypass patency [Elektronische Daten] [U. Schick, M. Zimmermann, D. Stolke] Summary: The EC-IC Bypass Study Group could not detect any benefit from surgery compared to medical management in the prevention of stroke in 1985 [15]. During the past years surgical revascularization was re-evaluated and considered as an appropriate treatment for a small subgroup of patients with recurrent focal cerebral ischaemia and impaired haemodynamics. This retrospective study examines the long-term benefit and patency rate of bypass. We present a follow-up of 5.6 years of 47 patients, all of whom underwent byupass surgery after 1985. Forty patients suffered recurring transient ischaemic attacks due to uni- or bilateral internal carotid artery occlusion. Examination included neurologic status, TCD with CO2 or Diamox challenge, angiography, CT and SPECT scans. Neurological improvement was seen in 23% of patients with better results after early surgery, a worsening in 22% suffering further ischaemic events on a postoperative average of 2.8 years. Patency rate for vein graft material was 50%, for the STA-MCA procedure 91%. Occlusion of the vein graft occurred on an average after 1.4 years, other anastomosis after 2.7 years. We conclude that only few patients derived long-term benefit from EC-IC bypasses. Functioning of the bypass worsens over time, suggesting a role for surgery predominantly in the first year of ischaemic events due to insufficient collateral supply. Actual indications for bypass surgery may be patients with failure of maximal medical therapy and progressive ischaemia and haemodynamic compromise. Springer-Verlag, 1996 EC-IC bypass nationallicence bypass function nationallicence bypass grafting nationallicence cerebrovascular reserve capacity nationallicence Schick U. Department of Neurological Surgery, University Hospital GHS Essen, Essen, Federal Republic of Germany aut Zimmermann M. Department of Neurological Surgery, University Hospital GHS Essen, Essen, Federal Republic of Germany aut Stolke D. Department of Neurological Surgery, University Hospital GHS Essen, Essen, Federal Republic of Germany aut Acta Neurochirurgica Springer-Verlag 138/8(1996-08-01), 938-943 0001-6268 138:8<938 1996 138 701 https://doi.org/10.1007/BF01411282 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF01411282 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Schick U. Department of Neurological Surgery, University Hospital GHS Essen, Essen, Federal Republic of Germany aut NATIONALLICENCE 700 1- Zimmermann M. Department of Neurological Surgery, University Hospital GHS Essen, Essen, Federal Republic of Germany aut NATIONALLICENCE 700 1- Stolke D. Department of Neurological Surgery, University Hospital GHS Essen, Essen, Federal Republic of Germany aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer-Verlag 138/8(1996-08-01), 938-943 0001-6268 138:8<938 1996 138 701 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer