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Microvascular Anastomoses for Cerebral Ischemia (Paperback, Softcover reprint of the original 1st ed. 1978)
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Discovery Miles 16 400
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Microvascular Anastomoses for Cerebral Ischemia (Paperback, Softcover reprint of the original 1st ed. 1978)
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We have witnessed a remarkable development during the past 10 years
in the development of extra-intracranial anastomosis to
revascularize the brain. Initially, the intention was to create
ameans of performing embolectomy in small corticaI arteries after
cardiac surgery. Gradually a plan was conceived to form an
extra-intracranial bypass(10) to treat inaccessible lesions of the
carotid and vertebral arteries as weIl as tumors and giant
aneurysms that involved these arteries. The basic techniques and
principles of microvascular sur- gery, which had been refined over
30 years on peripheral ar- teries(1-7, 9) were applied in 1966 to
the intracerebral arteries of dogs(4). The arterial patehing and
suturing were successful, while extra-intracraniallong bypasses
were a constant failure. This was attributed to the damage that was
inevitably inflicted on the vasa vasorum of the autogenous graft
during dissec- tion(9). This situation posed a dilemma until
eventually the idea of Pool and Potts(8) was adopted and an
anastomosis was performed on a dog between the superficiaI temporaI
artery and a cortical branch. Because of the vesseIs' small size
and the doubts regarding its capacity for improving the
circulation, the procedure was performed with a certain amount of
apprehen- sion. It was a pleasant surprise, therefore, to discover
that it was possible to attain a high rate of patency. If the
middle cerebral artery was us ed and was isolated from its carotid
in- flow, an even higher rate was achieved.
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