Neurológia pre prax 1/2010

Extra-intracranial bypass in arteria carotis interna occlusion

The use of extra-intracranial bypass (EC-IC) for secondary prevention of ischemic stroke dropped markedly after results of randomized multicenter EC-IC bypass trial in the mid 80th. Patients after ischemic stroke with proved ACI occlusion did not benefit from the surgery treatment. In the 90th a vast progression appeared in the area of functional examination of cerebrovascular compromise with the abilitiy to identify cerebrovascular reserve capacity. Upon small trials of patients with hemodynamic compromise there is clear positive effect of EC-IC bypass; though the new sufficient randomized trial proving the efficacy is missing. The paper is summary of recent knowledge used in indication of EC-IC bypass.

Keywords: EC-IC bypass, arteria carotis interna occlusion, cerebrovascular reserve capacity.