Is extracranial-intracranial bypass surgery effective in certain patients? (Reprinted from Neurologic Clinics, November, 2006)

Cerebral revascularization can be performed through a variety of extracranial-intracranial (EC-IC) bypass operations, using several different donor and recipient vessels, interposition grafts, and anastomotic techniques. The choice of bypass option is dependent on many factors, including the goals of the operation and the availability and accessibility of particular donor and recipient vessels. Potential indications for EC-IC bypass fall into two major categories: (1) flow replacement, in the treatment of complex aneurysms or tumors that require vessel sacrifice and (2) flow augmentation, for treatment of cerebral ischemia. The effectiveness of EC-IC bypass for these indications is reviewed in this article.