Aortocarotid bypass for hemispheric hypoperfusion in a child

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  • 1 Departments of Neurological Surgery and
  • | 2 Pediatric Neurology; and
  • | 3 Pediatric Heart Center, University of California at San Francisco, California
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✓ Large-vessel vasculitis syndromes in the pediatric population are rare and highly morbid. The authors here report on the microsurgical revascularization of a unique case of presumed vasculitis with aortitis and severe obliterative arteriopathy in a 10-month-old child with symptomatic hemispheric hypoperfusion. Using a cryopreserved saphenous vein, this unilateral aortocarotid bypass restored normal intracranial perfusion bilaterally and led to a resolution of the patient's ischemic symptoms. The aortocarotid bypass is clinically effective and technically feasible in young children when a saphenous vein allograft is used. The bypass graft is amenable to angioplasty with or without stenting if delayed stenosis becomes an issue later in life.

Abbreviations used in this paper:

CCA = common carotid artery; ICA = internal carotid artery; MR = magnetic resonance.

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